Serial low dose EOS x-rays spanning 3.5 years of scoliosis correction from detection to bracing to non-fusion Vertebral Body Tethering surgery I started doing more surgery focused research. I even lurked on Facebook scoliosis forums to see how other sco-liosis patients with severe curves were trying to manage their own care. Ridic-ulous? Actually, these groups were the most helpful. They shared information on non-fusion surgical scoliosis correc-tion techniques that use screws and cords to maintain spine flexibility. Vertebral body tethering (VBT) uses polyethylene terephthalate (PET) cords instead of metal rods to correct a scoliotic curve. The basic idea is quite elegant. Screws are inserted into the convex side of each vertebrae along the span of the curve. Cords are tensioned between each vertebrae to align the vertebral discs which reduces the curve. This technique harnesses the Huet-er-Volkman principle of bone growth modulation which proposes that bone growth is retarded by increased me-chanical compression, and accelerated by reduced loading in comparison with normal values. VBT is primarily for adolescents that are still growing. As they continue to grow post VBT, the discs and vertebrae will maintain a more symmetrical shape which will stabilize the cure once bone maturity has been reached. Fusion is avoided altogether. This sounded like a solution! Via e-mail, Linkedin, Instagram and Zoom, I began reaching out directly to spine surgeons across Canada, the USA and Europe. These specialists were the most skilled in non-fusion scoliosis surgeries and I sought a con-sensus of opinion. Six consultations later, we drove down to Shriners Hos-pital for Children in Philadelphia to see pediatric orthopedic and neurosur-geon, Dr. Amer Samdani. Dr. Samdani not only led the research necessary for www.Cndoctor.ca the FDA VBT approval (summer 2019), he had also performed over 250+ VBT surgeries. His clinical deci-sion making, experience and expertise meant everything. On Labour Day 2019, he accepted Jacob as a surgical candidate for VBT and in December 2019, my son had VBT surgery. One and a half years later, my son’s curve is down to 24 degrees from 53 with a fully mobile spine. Everyone’s influences and approaches will differ, and chiropractors, naturo-paths, osteopaths and physiotherapists will lean on their experience and train-ing to try and find a solution. But what about parents and patients? What should they do, and who advocates for them? Researching scoliosis treatment options is a challenge considering all the Alanay in Turkey to see if he would be interested in participating in an inter-view on VBT. Shockingly, he agreed and we recorded a 70-minute interview. Not only did I learn more about VBT, but the interview gave insight to Dr. Alanay’s thought processes regarding surgical decision-making and surgical approach, but also his personality. This long format interview reveals much more than a typical 10 minute consul-tation most patients get with a surgeon. Maybe I was on to something. A year later, I’ve interviewed 30 of the top spine surgeons from Canada, U.S., Germany, France and Australia. That list includes Dr. Amer Samdani, Dr. Peter Newton (San Diego), Dr. Per Trobisch (Germany), Dr. John Braun (Boston), Dr. Noelle Larson (Mayo My previous consultations taught me so much – why not share these insights...? misinformation and lack of consensus on the Internet. From my own experience, I have learned the best and most relevant data and information comes directly from spine surgeons, especially the ones that publish research papers consistently. This means they follow up with patients long term and are experienced and re-spected by their peers. My previous consultations taught me so much – why not share these insights with other par-ents or patients affected by scoliosis? Last spring during the first COVID lockdown, I reached out to Dr. Ahmet Clinic) and many more. I’ve also inter-viewed scoliosis researchers, orthotists and other practitioners. These inter-views have become popular in the scoliosis world and I’m happy parents can use this resource to make timely and informed decisions. The interviews can be found at https://www.youtube. com/c/DerekLee. The only way parents and patients can advocate for themselves is by edu-cating themselves as best they can. It doesn’t matter if you are a practitioner or a parent. Keep that in mind and it will serve you well. Photo: Author provided. September/October 2021 Chiropractic and Naturopathic Doctor 15
Chiropractic + Naturopathic Doctor September/October 2021: Page 15
