The FDA recently approved two more scoliosis spinal fusion surgeries: Vertebral Body Tethering (VBT) and ApiFix. I’ve been reading about these two surgeries for years and am hopeful they will be good alternatives to the rod fusion surgeries that are currently done, but only time will tell.
While I am not an advocate of spinal fusion surgery for scoliosis, I do understand that there are cases where spinal surgery may improve someone’s quality of life. The standard scoliosis spinal fusion surgery involves two long metal rods that are screwed into every vertebra along the length of the rod, leaving the surgically fused area absolutely motionless for the rest of that person’s life. It is one of (if not the) most dangerous spinal surgeries currently practiced. The downtime for this surgery is months, deaths can happen on the table due to too much blood loss from the length of the surgery, and serious problems can occur as a person ages because the spine cannot move. After all, our bodies were created to move.
What is VBT and how is it different?
VBT is just as invasive as the current rod surgery since a screw is still placed in every vertebra, but instead of a rod, a “tether” or rope, is attached to the convex side of each curve pulling it taught and making the spine straighter. The upside to this surgery is the spine still has flexibility and can move. This surgery is still too new to know how the tether will hold up in the long-run and how many revision surgeries may end be necessary.
What is ApiFix and how is it different?
ApiFix is the surgery that is most intriguing to me. A small ratcheting device is screwed into the concave part of one’s major curve in only two places, the top vertebra and the bottom vertebra. This is truly a minimally invasive surgery. The surgery is about 90 minutes long with a hospital stay lasting 1-2 days. People are back to life in a few weeks.
Instead of forcing the spine straight during the surgery, which the other surgeries do, the approach with ApiFix is different. Once the body is healed from surgery, the patient is taught to simply do breathing and lengthening exercises through the concave part of their spine (this is what people who have scoli but aren’t fused do!) and the device will “ratchet” up a notch, making the spine straighter. This process is continued slowly over time until the person feels they are as straight as their body can be. The few vertebrae that are attached to the ApiFix device will be non-mobile as long as it remains in the body. Again, this surgery is still too new to know if and when revision surgeries will be required.
Should you have spinal fusion, VBT, or ApiFix surgery? Is there another alternative?
As for me, I’m not having surgery for my scoliosis—and never plan on it. Movement is my medicine and what I recommend for the majority of my clients.
If you want guidance on how to start moving wisely for your scoli, check out Spiral Spine Scoliosis Resources. If you want to experience the healing side of what movement can do for scoliosis, come to Spiral Spine Pilates studio for the Scoliosis Intensive workshop. We have two scheduled for 2020*: March 6-7 and June 26-27. If you’ve never experienced how great your spine can feel after wonderful movement, come spend a weekend with me and my staff!
*Scoliosis Intensive is offered regularly throughout the year. Be sure to check our workshops page for the most up-to-date schedule.