Tether

Tether Procedure for Children with Scoliosis

Scoliosis refers to a condition in which the spine curves abnormally to the side. It can occur at any age, but for the majority of cases, doctors find the condition in children and adolescents. Additionally, the condition can get worse during the growth spurt that occurs just before puberty.

In children with scoliosis, the spine may curve to the side in a “C” or “S” shape. Also, the severity of the curve can vary widely, from mild to severe. In contrast, mild cases may not cause any noticeable problem.  However, in severe cases it can cause pain, difficulty breathing, and an abnormal appearance.

Detection

Doctors normally detect Scoliosis  during a routine physical exam.  It can sometimes show in a child who demonstrates an uneven shoulder blade or hip.  Sometimes doctors see a patient whose head does not appear centered over their body. If doctors suspect scoliosis, the child will usually undergo further testing, such as an X-ray.  Consequently, this will confirm the diagnosis and determine the severity of the curve.

Treatment

Treatment for scoliosis in children typically depends on the severity of the curve and the child’s age. For mild cases, your doctor may just want to watch the child and not initiate any treatment. In more severe cases, treatment may include the use of a back brace, physical therapy, or, in severe cases, surgery. The goal of treatment is to stop the curve from getting worse and reduce the curve to improve the child’s appearance and mobility.

Treatment Options include:

• Observation: For mild cases of scoliosis, the curve may not appear severe enough to require treatment. In these cases, the doctor may monitor the child to ensure that the curve does not get worse.
• Bracing: In cases where the curve appears more severe, the doctor may recommend a back brace to help support the spine. Also, it prevents the curve from getting worse. The child will need to wear the brace for most of the day.  The brace will adjust as the child grows.
• Physical therapy: Physical therapy can help improve the strength and flexibility of the muscles around the spine.  This can sometimes reduce the severity of the curve.
• Surgery: In severe cases, the doctor will suggest surgery to correct the curve in the spine. There are several different types of surgical procedures that treat scoliosis.

Surgical Options

Parents should discuss all of the treatment options with their doctor to determine the best course of action for the individual child. There are several different types of surgical procedures that correct scoliosis in children, depending on the severity of the curve and the child’s age. Some of the most common surgical procedures used to treat scoliosis in children include:

• Spinal fusion: During spinal fusion surgery, the surgeon will attach two or more vertebrae together using metal rods, screws, or hooks. The goal of spinal fusion is to straighten the spine and prevent the curve from getting worse.
• Vertebral column resection: During this procedure, the surgeon will remove part of a vertebra to correct the curve in the spine. This procedure is typically used in cases where the curve is severe and spinal fusion alone will not cause a successful outcome.
• Tethering: Tethering is a newer surgical procedure that involves attaching a flexible device, called a tether, to the spine to hold it in place while it grows. The tether consists of materials such as silicone or polyethylene and attaches to the spine using screws or hooks. Doctors use tethering in cases where the curve appears severe and does not respond to other forms of treatment, such as bracing or physical therapy.

The Tether Option

It is important to discuss all of the surgical options with a doctor to determine the best course of action for the individual child. As with any surgical procedure, there are risks involved, including infection, nerve damage, and bleeding.

Scoliosis tethering is a surgical procedure used to treat scoliosis, a condition in which the spine curves abnormally to the side. Scoliosis can cause a variety of problems, including pain, difficulty breathing, and an abnormal appearance. Tethering is a relatively new procedure that is used to correct scoliosis by using a device called a tether to hold the spine in place while it grows.

The Tether Procedure

The procedure is usually performed on children and adolescents who have not yet finished growing.  This is because their bones are still developing and are more flexible than those of adults. It is used in cases where the curve in the spine is severe and is not responding to other forms of treatment, such as bracing or physical therapy.

The procedure is typically performed under general anesthesia, so the patient will sleep during the surgery. The surgeon will make an incision in the back, usually along the spine, and expose the affected area. The surgeon will then attach the tether, made of silicone or polyethylene, to the spine using screws or hooks. The tether is then tightened to straighten the spine and prevent further curvature.

Once the tether is in place, the surgeon will tighten it to straighten the spine and prevent further curvature. The tether will slowly straighten the spine. The surgeon may access other parts of the spine that need correction. The entire procedure typically takes several hours to complete.

After Surgery

After the procedure, the child will typically need to wear a back brace for a period of time. This will help support the spine and ensure proper healing. Doctors will recommend physical therapy to help strengthen the muscles around the spine and improve mobility.

The Benefits of the Tether

The tether procedure, also known as tethering, is a surgical treatment for scoliosis.

There are several potential benefits to using the tethering procedure to treat scoliosis in children:

• Straightens the spine: The tether is tightened to straighten the spine and prevent further curvature.  This can improve the child’s appearance and mobility.
• Less invasive: Tethering is typically less invasive than other surgical procedures for scoliosis, such as spinal fusion.  Spinal fusion involves attaching metal rods to the spine. This may lead to a shorter recovery time and fewer complications.
• Allows for continued growth: Because the tether is flexible, it allows the spine to continue growing while still holding it in place. This can benefit children and adolescents who have not yet finished growing.
• Allows for adjustment: Doctors can adjust the tether as needed to ensure that the spine is being held in the proper position. This allows for more precise correction of the curve and may lead to better long-term results.

It is important to discuss all of the potential risks and benefits of the tethering procedure with a doctor before deciding on this treatment option.

Efficacy

Overall, we at the Medical City Children’s Orthopedics and Spine Specialists find the Scoliosis Tether procedure as a relatively safe and effective treatment for Children with scoliosis, but as with any surgical procedure, risks need consideration. These may include infection, nerve damage, and bleeding. It is important to discuss all of the potential risks and benefits with doctors who are experts in this new important procedure.

Why Choose Medical City Children’s Orthopedics and Spine Specialists

Orthopedics is a specialty of our doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists. They understand your concerns, can answer your questions regarding your condition, and know how to use their specialized knowledge to assist you.  Richard Hostin, MD,  Shyam Kishan, MD, and Kathryn Wiesman, MD, have many years of training and experience in Spine and Back Pain for kids, and adolescents, and can help them get back to living the life they love.

The following are just a few of the many reasons why patients might choose Medical City Children’s Orthopedics and Spine Specialists.

• Expertise in the spine: The team of specialists are spine experts.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
• Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
• Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  We ensure that patients receive complete, seamless care for their spinal conditions.
• Dedicated facilities: Medical City Children’s Orthopedics and Spine Specialists is dedicated to providing patients with a safe and comfortable environment.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their spine patients. Medical City Children’s Orthopedics and Spine Specialists maintains offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX and offer cutting-edge technology, comprehensive care, and dedicated facilities to ensure the best possible care for their patients. Call today to make an appointment for your child.

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National Institute of Health: The Tether Procedure