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View Full Version : Fusionless Surgery / Wedge Osteotomies



livingtwisted
03-05-2011, 10:45 PM
I'm starting a new thread on this since I don't think there has been one, at least not for some time. Here are the links hdugger (thank you!) dug up about it. From what I gather it has only been used on growing kids so far, but I'm trying to understand why this wouldn't be a nice option for the skeletally mature as well.

http://www.spineuniverse.com/conditions/scoliosis/new-surgical-treatments-scoliosis-vertebral-body

http://www.spineuniverse.com/professional/research/srs/2005/fusionless-surgery-scoliosis-2-15-year

Here's an article that succinctly summarizes the current (at least up until a few years ago) thinking as to the reasons to go this way: http://www.scoliosisjournal.com/content/3/1/6

Does anyone have any more info on this or personal experience with it? Are other doctors performing it? What about for adults?

Resilience
03-06-2011, 10:13 AM
The Vertebral Body Stapling website has a list of physicians, many seem to be pediatric specialists but some look like adult and pediatric surgeons.

www.vertebralstapling.com/Physician_List.html

I'm just starting to look into this as a possibility for my daughter. From my understanding VBS is only indicated in a growing child up to a point in terms of their cobb angle and skeletal maturity status.

It's worth looking into though! Best wishes to you!

livingtwisted
03-06-2011, 12:00 PM
Thanks! I was under the impression that VBS was for growing kids and is only semi-permanent. But I guess I haven't done much research on it for that reason. I was more interested in the part about wedge osteotomies and wondering why that isn't more widely used. Is it that the correction achieved isn't as great?

livingtwisted
03-06-2011, 12:32 PM
I had the sense from the articles that the wedge osteotomies were still in the exploratory stage. They talk about using them for patients with spinal injuries or those who are paralyzed, which suggests to me that they're a little concerned that they might do damage if they did them in an uninjured spine.

That makes sense. I was trying to understand this sentence:


To avoid fusion for patients with paralysis, for whom maintaining spinal flexibility and mobility is more desirable, fusionless, vertebral wedge ostetomies are developed for the treatment of progressive paralytic scoliosis of skeletally immature children with spinal cord injury or myelodysplasia [25]
http://www.scoliosisjournal.com/content/3/1/6

I don't know enough about paralysis to understand why flexibility is more desirable. I would think it's more desirable for everyone. But even if they are using paralyzed patients as a test group, it seems that they are still all children.

livingtwisted
03-06-2011, 12:48 PM
Ok, I fail for reading comprehension. Both the links you posted seem to be about the skeletally mature. How do I find a doc who is doing this?

Resilience
03-06-2011, 08:16 PM
Janet is Dr. Betz's Physician Assistant and has set up an email to connect with potential patients. She wouldn't mind if you contacted her by email with your question.

janetcerrone@comcast.net

livingtwisted
03-06-2011, 09:23 PM
Janet is Dr. Betz's Physician Assistant and has set up an email to connect with potential patients. She wouldn't mind if you contacted her by email with your question.

janetcerrone@comcast.net

Thank you! I was ready to start with the main number for the hospital tomorrow am!

mariaf
03-07-2011, 09:02 AM
The vertebral staples are permanent, I believe, in the sense that you don't have to remove them. But I would guess that once a child has stopped growing they could be removed without losing the correction. But, I haven't really researched them enough to know that.

That's pretty much the case - originally, the plan was to perhaps remove the staples but since they have not caused any issues over the past decade or so that they have been in use, nobody is rushing to remove them since it would require another surgery.

And, yes, even though Dr. Betz treats children, he recently recommended an adult doctor in NY for a friend of mine. These guys all seem to know each other which isn't surprising when you think about it.

livingtwisted
03-11-2011, 07:18 PM
Just wanted to share the info I got back from Dr. Betz's office... apparently after the initial study 10 years ago using adolescents with paralytic scoliosis, no further progress was made, which seems to be a funding issue. I couldn't find a date on the article from Spine Universe so who knows when that was posted. So at least in the US no one is currently practicing this method, although there was also a Japanese study that seemed successful.