Page 12 of 12 FirstFirst ... 2101112
Results 166 to 177 of 177

Thread: Scott's Vertebral Body Tethering Thread

  1. #166
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,111
    Also here is Newton making the point I made about whether tethering preserves significantly more ROM than fusion...

    https://ryortho.com/breaking/study-t...oliosis-cases/

    “Despite these challenges, a spinal fusion has been prevented in the majority of cases. However, the ‘true’ benefit of the retained motion relative to what would have likely been an isolated thoracic fusion can certainly be questioned. The differences in global trunk motion appears to be only modestly affected by a thoracic spinal instrumentation and fusion.”

    “There is growing interest in fusion-less treatment for scoliosis. Internet sources and social media in my view often paint a picture praising tethering and damning fusion. This is biased and inaccurate. Patients need clear and balanced information on the pros and cons of tethering vs. fusion. My hope is this paper will offer some of the facts required to inform such discussions.”

    “In my view, tethering is reasonable for the growing patient with a scoliosis beyond 45 degrees. They need to understand an attempt to avoid fusion with a growth modulating tether will be less reliable and have a higher revision rate than posterior spinal fusion. Some will value motion over the absolute correction or the greater chance of revision. Others will value the most reliable approach at the expense of a modest loss of motion. Shared decision making is mandatory.”
    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. #167
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    Quote Originally Posted by Pooka1 View Post
    I don't see where that is written. Also it sounds like either the tether broke in 3 places or broke and was replaced 3 times.
    From the same study linked above:

    Table II: Broken Tether Data

    Number of broken levels per patient
    1 level: 7
    3 levels: 1
    He was very clear at our first meeting that he believed the tethers would not be long lived. In his study they started snapping at 18 months.

    From the same study,

    A more robust implant would be ideal, although an implant with a fatigue life of decades rather than years seems unlikely. Further development is necessary.
    It's only going to last a few years.
    Last edited by Dingo; 11-23-2018 at 07:39 PM.

  3. #168
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,111
    Table II: Broken Tether Data

    Number of broken levels per patient
    1 level: 7
    3 levels: 1
    That means the one tether broken at three locations. That is because it is anchored at every level so the whole thing doesn't lose tension if it breaks. The residual tension broke it in two other places. That one kid obviously had a curve that was determined to progress.

    Did Newton tell you there were 7 short tether segments? All the photos seem to show one long tether and the descriptions all indicate one long tether that is tensioned.
    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."

  4. #169
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    By the way as I watch this video Pooka is correct. It's one long tether separated into segments by metal implants.

    Video: New Procedure to Treat Scoliosis at BC Children's

    Scott's 6 month checkup is in about 3 months. I'll ask Dr. Newton if every level will eventually snap. Based on our first conversation I believe the answer will be yes. The tether deteriorates and is not long lasting.

  5. #170
    Join Date
    Jan 2008
    Location
    NC
    Posts
    9,111
    In the commentary on Newtons article, they said the concept has been proven. I think the game is over and tethering will eventually replace most fusions.
    Now it is just a game of minimizing/avoiding complications.
    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."

  6. #171
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    Quote Originally Posted by Pooka1 View Post
    In the commentary on Newtons article, they said the concept has been proven. I think the game is over and tethering will eventually replace most fusions.
    Now it is just a game of minimizing/avoiding complications.
    For us tethering made sense because it allowed Scott's spine and chest to continue growing. So even if it failed and he was eventually fused it wouldn't be until after he was full grown.

    I think eventually tethering will make sense for most kids with Scoliosis but it might not be mainstream for a decade or two.

    From the study,
    The ultimate potential benefit (or harm) of attempting to avoid spinal fusion with ASGT for patients with scoliosis may not be evident for decades.
    Also if a child (like Scott) is fused before he is done growing his curve may continue to progress until he reaches maturity.

    Vertebral growth after posterior spinal fusion for idiopathic scoliosis in skeletally immature adolescents. The effect of growth on spinal deformity.
    From one year after surgery to the latest review, the percentage anterior disc height decreased by nearly one-half and the percentage posterior disc height by nearly one-third in the fused segments (p < 0.001). There was a 4 degree increase in mean Cobb angle (p < 0.001), 11 patients (37%) having an increase of between 6 degrees and 10 degrees. There was a significant increase in mean apical rotation by 2 degrees (p = 0.003), and four patients (13%) had an increase of between 6 degrees and 16 degrees. There was little change in kyphosis.

  7. #172
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    Tiny update.

    Scott lives about 1 mile from high school. Without prompting he decided that jogging home from school would be fun.

    He's done it two days in a row and both times he said his back felt fine.

    Before surgery he had a hard time standing for more than a few minutes let alone running.

    So in his case VBT caused a huge reduction in back pain.

  8. #173
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,815
    Dingo

    I see he is roughly 4 months now....time flies, does he feel any of the hardware at all. In any positions?

    Is he completely recovered now? 100%?

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  9. #174
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    Quote Originally Posted by titaniumed View Post
    Dingo

    I see he is roughly 4 months now....time flies, does he feel any of the hardware at all. In any positions?

    Is he completely recovered now? 100%?

    Ed
    He just got home from school so I asked him how he felt at the 4 month mark.

    Laying down) 0% pain
    Standing) 0% pain
    Walking) 0% pain
    Exercise) 0% pain
    Jogging) 0% pain
    Sitting) If he sits for a long time his back can start to get sore. He pointed to the area and it's roughly the area of the tethering.

    In addition on the front of his chest there is a small area on a rib that is slightly numb. Around that area is some soreness that is noticeable if he touches it. It's been that way since the surgery.

    So basically movement feels great. Sitting can become irritating if it's for a long time.

  10. #175
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,815
    Sounds pretty good.....

    Numbness can happen after surgery. Some of it is predictable, some isn't . Peripheral nerves do heal, so its a wait and see thing. The spinal cord is a different story.

    Sitting can be difficult for us. Sometimes, its EXTREMELY painful..... I had a lot of trouble sitting in the car before my surgeries. I also didn't sit down much at work, which means you have to work twice as fast before you pass out.

    For many of us, we can only get a break by laying down.

    Its nice to see this positive experience with Scott.

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  11. #176
    Join Date
    Mar 2009
    Location
    Arizona
    Posts
    1,053
    Quote Originally Posted by titaniumed View Post
    Sounds pretty good.....

    Numbness can happen after surgery. Some of it is predictable, some isn't . Peripheral nerves do heal, so its a wait and see thing. The spinal cord is a different story.

    Sitting can be difficult for us. Sometimes, its EXTREMELY painful..... I had a lot of trouble sitting in the car before my surgeries. I also didn't sit down much at work, which means you have to work twice as fast before you pass out.

    For many of us, we can only get a break by laying down.

    Its nice to see this positive experience with Scott.

    Ed
    Yeah I hope that sitting gets better as his back slowly corrects as he grows. (crossing fingers)

    The tiny irritation on one rib is no big deal at all. He doesn't care about it and I believe it has slowly improved over the last 4 months.

    We lifted weights tonight and he's getting physically stronger (and a little bigger) each week.
    Another year and he'll be bigger than me. 8-)

  12. #177
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,815
    Over the years before my surgeries, I was a "fidgety" sitter, requiring movements for various reasons. I was an extremely active individual....The old aches probably had something to do with this, perhaps due to soft tissue and muscular imbalance problems. Many of us have this aching, stiffness and binding which can present itself in younger years living with scoliosis. The binding is what drove me to a Chiropractor when I was 28. (A long time ago) I don't know if smaller scoliosis curves (10-30 degrees) produce any binding. (In adults, over 18)

    If one has the underlying contributing factors of scoliosis, and they get corrected with a tether, will this continue? It would seem that tethering patients would be good candidates for before and after EMG studies. I am not seeing too much about this online.

    Do the imbalanced muscle systems correct themselves after scoliosis tethering? If so, how much?

    Ed
    49 yr old male, now 60, the new 55...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •