Vertebral Body Stapling

For those of you dealing with weighing various Scoliosis treatment options, there are constantly new kids in town to consider.  The newest one that a customer brought to my attention is Vertebral Body Stapling (VBS), or, even newer – Vertebral Body Tethering (VBT).  You can see many details about the procedure here: Study on Vertebral Body Stapling, but essentially it is a surgical option to bracing that is intended to prevent the more invasive spinal fusion in the future.  Not many Doctors do the procedure, but it is gaining popularity.  I will focus on VBS, but feel free to do some internet searches on VBT – it is even newer than VBS, and is only approved for Thoracic curves right now.  VBS uses Nickel and Titanium blend staples to hold the vertebrae in the thoracic and lumbar spine area in place while the patient grows, essentially, slowing down or hindering the progression of the patients’ curves.  One may think of it as an internal alternative to bracing.  The customer who contacted me went ahead and had the procedure done on her daughter and they are very happy.  The surgery is minimally invasive (small slits are placed on the side of the patient and the staples are inserted using fluoroscopic imaging).  However, it is still surgery, complete with the dangers of general anesthesia and with the pain and recovery time.  Recovery is a few days in the hospital, followed by a few weeks of restrictions.  Then, patients can resume nearly every activity they did before surgery.

The theory is that VBS can help slow down progression of curves and prevent spinal fusion.  HOWEVER, the following are some of my personal observations.  First, this procedure is new.  The study I link to above shows some longer term data, but there is not much data out there for long term (past 1-2 years post surgery).  Second, this procedure is for idiopathic ADOLESCENT Scoliosis only.  For those of us with 5 and 6 year olds with curves, this may be an option later, but it is not now (that I found).  Third, it works best on SMALLER CURVES (less than 40 degrees), on patients with growth left.  So, as with everything I recommend, the earlier you act the better.  However, many parents (including myself) are hesitant to do any surgery without first trying a brace.  Therefore, VBS is really great for the kids who will NOT comply with a brace, but who want to avoid possible fusion in the future.

The question is, of course – would I consider this, given everything we have been through with my kids to prevent surgery?  And, my answer is still that I would go the route of the RSC brace FIRST and, if no correction is achieved, I may consider this for my son (it is a moot point for my daughter, as she is already fused).  And, this is only if he would qualify – he is over 10 now, and has a lot of growing to do, but he was diagnosed with Juvenile Scoliosis, so he may not qualify yet.  As with any treatment, there are pros and cons.  Those staples will always be there, inside my child.  I have seen such improvement with my son by bracing alone (with a really good RSC brace), that I would still try that route and try to give him a chance at avoiding the surgery and avoiding a life with the staples in his spine.  However, I see the many benefits to the families who cannot bring themselves to brace or whose children will not tolerate it.  I still think it is better than doing nothing and I really hope more research will come out on this procedure in the near future.  It offers a wonderful option, but it’s still not a cure or a solution.  It is another way to cope, and we all need to find our own path to coping with Scoliosis.  You can link to a wonderful parent-led informational and support group for VBS here.  If your child has undergone this procedure, please feel free to write a brief synopsis of your story in the comments section.  I would love to hear more about it!

Would we change it if we could?

I was  having a conversation lately with a Mom in the middle of the adoption process.  She was explaining to me how they are able to put some specifications into the database for potential babies so they can try to reduce the chance of certain conditions and illnesses.  Although this is a helpful thing for prospective adoptive parents, it got me to thinking…aside from the choices I made for my health during pregnancy, I didn’t have any choice about the condition of my offspring.  Yes, I did plenty of things to increase their chances of health (I ate well, exercised, breastfed, etc), but the reality is that even if parents do adopt and all of their potential health risk factors are eliminated, they still have no idea what will be presented in that child later down the road.  Nor would they have changed their decision once that baby is placed in their arms – they are together for better or for worse. forever.  The reality is that you are dealt a certain hand and, as a parent, we can only have our pity party for so long before we must forge ahead and start dealing with that hand, regardless of if was preventable, or not.  When my daughter was diagnosed with Scoliosis at the age of 5, I was caught completely off-guard.  Even with our family history (and my husband’s), I never anticipated it – I was just carrying on with life.  But, it sure stopped us in our tracks.  Yes, I’ve cried many times over the extra challenges that my daughter (and son) will face because of their Scoliosis diagnosis.  But, I am sure any parent would agree, that we wouldn’t trade in that child and all of their problems if we had known ahead of time that we would face this.  Crystal ball or not, our children are who they are because of the total of all they are made of – the good and the bad.  Some things in our kids are “fixable”, like a propensity for sassy-ness and tantrums, but some things just are not.  And, when a parent is a problem – solver like this Mom, it can create a lot of stress.  I can fix almost anything!  But, I can’t fix this.  I can only manage it and live through it and take it as it comes.  I can research and plan and strategize and get my children the help they need, but I cannot fix it.  Darn.  Now, would I keep the exact same child and take away the Scoliosis if I could?  That is awfully tempting.  On one hand, I know my daughter is a completely different person because of this condition and all the challenges it has presented to her in her young life.  And, I wouldn’t change the person she is right now for ANYTHING.  She is tougher, more sympathetic, more hard working, more diligent, more accepting, better at taking on challenges, and has a deeper faith because of it.  But, would I trade all that to take away the pain she has been dealt and that she will be dealt in the future?  Do I dare test the Master’s plan?  Luckily, I cannot.  These are the children I have been given – and I thank God for it!  Both my children’s Scoliosis has been a major obstacle – one they will deal with the rest of their lives.  One of many obstacles.  So, would you change it if you could?