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Juvenile Idiopathic Scoliosis
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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Current indications for VBT are immature, moderately severe curves that are flexible — Lourina Flakari, 2025 Pediatric Surgery Update Course - Vertebral Body Tethering (VBT) for Scoliosis · 0:26
2025 Pediatric Surgery Update Course - Vertebral Body Tethering (VBT) for Scoliosis
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On August 26th, the largest Pediatric Surgery course in the world each year was held, where top hospital experts from around the US will discuss this year’s changes in practices and innovation. Learn more about the future of pediatric surge
video15:50 · Aug 2025
Update Course Rewind 2025: Vertebral Body Tethering (VBT) for Pediatric Scoliosis
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This video, featuring experts from Cincinnati Children's and Akron Children's, provides an in-depth look at Vertebral Body Tethering (VBT) for pediatric scoliosis. It covers clinical scenarios, highlighting VBT's advantages as a minimally i
video5:39 · Jun 2026
Vertebral body tethering for pediatric scoliosis: patient selection and surgical technique
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This video, featuring experts from Cincinnati Children's and Akron Children's, provides an in-depth look at Vertebral Body Tethering (VBT) for pediatric scoliosis. It covers clinical scenarios, highlighting VBT's advantages as a minimally i
podcast5:39 · Nov 2026
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Update Course Rewind 2025: Vertebral Body Tethering (VBT) for Pediatric Scoliosis
Vertebral body tethering is an FDA approved minimally invasive non-fusion surgical treatment for growing patients with idiopathic scoliosis.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position1:18 ↗
VBT is less invasive and more physiologic than standard spinal fusion.
opinion1:05 ↗
VBT uses a polyethylene flexible band placed on the convex side of the spine.
clinical1:32 ↗
VBT requires a skeletally immature patient so that as they grow, they grow straighter.
clinical1:37 ↗
If VBT is done in a mature patient, it is probably not going to work.
clinical1:49 ↗
VBT only works in kids because you have to grow; you cannot use this in adults.
clinical1:53 ↗
People doing VBT in adults have outcomes that are not very good.
clinical1:56 ↗
Everybody is moving towards only doing VBT in skeletally immature kids right around the time of peak growth velocity.
clinical2:01 ↗
If VBT is done too early, you overcorrect.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position2:11 ↗
Peak growth velocity occurs when kids are going through a period of significant skeletal growth around ages 8 to 15.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position2:14 ↗
If VBT is done too late, the tethering will eventually break and the spine will revert back to its initial shape.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position2:22 ↗
The sweet spot for VBT is when we can actually modulate growth and change the shape of the disk space and the shape of the vertebrae as they grow.
clinical2:28 ↗
Current indications for VBT are immature, moderately severe curves, and flexible.
guideline2:40 ↗
Hybrid techniques are being done where if the thoracic curve does not meet criteria, the lumbar spine is where you need motion, so you can do a hybrid.
clinical2:47 ↗
You can usually get down to T12, L1 through the thoracoscopic approach and bluntly dissect the plane along the diaphragm to get to that level.
clinical3:01 ↗
L1 to L4 is accessed through an open incision.
clinical3:11 ↗
Segmental vessels are typically ligated during VBT.
clinical3:15 ↗
You certainly do not want to ligate segmental vessels on both sides of the spine due to risk of a spinal infarct.
clinical3:18 ↗
L1 can be accessed more easily thoracoscopically than by open surgery.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position3:23 ↗
L2 through L4 is better accessed by open approaches and removing one of the floating ribs.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position3:28 ↗
Lumbar exposure can be challenging, especially distally because of the iliac crest.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position3:40 ↗
Be really careful around the lumbosacral plexus during VBT.
clinical3:44 ↗
EMG neuromonitoring is used during VBT.
clinical3:47 ↗
You can bluntly retract the psoas off the vertebral body during VBT.
clinical3:50 ↗
The key is to bluntly retract the psoas off of the vertebral bodies during the open approach and make sure you are around the entire psoas muscle.
Host summaryJill Knepprath summarizing the discussion — not the host's own clinical position3:56 ↗
The tether is threaded through each screw and a tensioning gun is used to place tension.
clinical4:05 ↗
VBT patients are mobilized immediately postoperatively.
clinical4:14 ↗
VBT patients return to sports within 6 weeks, compared to typical return to sports for a fusion of 3 to 6 months.
clinical4:16 ↗
A Mayo study showed VBT success rate of only 75% at 2 years based on curve size and lack of revisions.
epidemiological4:26 ↗
The Mayo study showed VBT success rate down to 63% at 3.8 years with a 20% revision rate.
epidemiological4:36 ↗
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