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Thread: An HSS surgeon gives his opinion on tethering

  1. #1
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    An HSS surgeon gives his opinion on tethering

    Questioner: Do you think VBT will pan out? How can the tether correct the curve in the coronal plane and not create problems (flatback, hypokyphosis, etc.) in the sagittal plane? Thank you in advance.


    Hospital for Special Surgery: "It will not pan out for all curve types. It will only work for some limited indications in my opinion." - Dr. Han Jo Kim, HSS spine surgeon
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  2. #2
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    Burdle or someone on the VBT FB page, do you think people there would be interested in seeing this quote? If so can you please post it there? Thanks
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  3. #3
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    Quote Originally Posted by Pooka1 View Post
    Burdle or someone on the VBT FB page, do you think people there would be interested in seeing this quote? If so can you please post it there? Thanks
    The group is very sensitive. I think the members would just round on the poster.

    That is kind of the trouble. Anecdotal experience is presented as fact. This is why I prefer a forum as you can pursue debate more easily.

    On Facebook they still say that VBT is done on adults. Two women in their 50s have had it done on a thoracic curve. There is no evidence presented as to whether the curve was progressing. There have been other fully grown patients - VBT outside of Shriners on kids seems to just be under the care of about 3 surgeons who have specific parameters but not sure what they are. Yet if you ask everyone will say that it is done on adults

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    Quote Originally Posted by burdle View Post
    The group is very sensitive. I think the members would just round on the poster.

    That is kind of the trouble. Anecdotal experience is presented as fact. This is why I prefer a forum as you can pursue debate more easily.

    On Facebook they still say that VBT is done on adults. Two women in their 50s have had it done on a thoracic curve. There is no evidence presented as to whether the curve was progressing. There have been other fully grown patients - VBT outside of Shriners on kids seems to just be under the care of about 3 surgeons who have specific parameters but not sure what they are. Yet if you ask everyone will say that it is done on adults
    Well that is pretty interesting. While I think there is cause for hope, folks should never be deliberately misleading. It is probably important to differentiate between young adult and older adult in this case.

    I posted a study on the pros and cons of fusion on teenagers versus waiting into YOUNG adulthood and even there the issue of stiffer curve was present. Then you map that onto older adults when flexibility is an issue in whether or not VBT is indicated and I think the message should not be "VBT is done on adults" but rather "only two older adults have ever been tethered to anyone's knowledge, likely because many/most other candidates did not have the requisite curve flexibility. VBT, for the moment, largely remains an experimental treatment in growing children."
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  5. #5
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    Quote Originally Posted by Pooka1 View Post
    Well that is pretty interesting. While I think there is cause for hope, folks should never be deliberately misleading. It is probably important to differentiate between young adult and older adult in this case.

    I posted a study on the pros and cons of fusion on teenagers versus waiting into YOUNG adulthood and even there the issue of stiffer curve was present. Then you map that onto older adults when flexibility is an issue in whether or not VBT is indicated and I think the message should not be "VBT is done on adults" but rather "only two older adults have ever been tethered to anyone's knowledge, likely because many/most other candidates did not have the requisite curve flexibility. VBT, for the moment, largely remains an experimental treatment in growing children."
    I think those parents of kids who have had VBT are so relieved they just want to pass on good news. There are more than two adults who have had VBT when fully grown but that is not quite the same as 'adults in general'; nevertheless it is done on people where there is no growth left which means there is future possibility of bone remodelling and who knows in the future. However it is a very supportive site and sort of gives the message that it is worth pursuing as an adult. This fine but not so fine when you have to travel abroad for consultation and surgery ( It isn't done at all in UK)


    However the counter to the surgeon of your quote will be the quotes from the surgeons who do VBT?

  6. #6
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    Quote Originally Posted by burdle View Post
    However the counter to the surgeon of your quote will be the quotes from the surgeons who do VBT?
    Yes. Lonner said he watched for 5 years before he had seen enough data to jump in. Another surgeon mentioned the same issue that Lonner did though.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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