The distinction between Anterior Scoliosis Correction (ASC) and Vertebral Body Tethering (VBT) is an important one best represented by who can be treated.
Scoliosis inherently is a process by which the spine is already tethered. In our opinion, the terms ‘tether’ and ‘tethering’ used to describe the technique we perform are not medically accurate. In most cases, spinal curvatures like scoliosis, and particularly with hypokyphosis, need to be “de-tethered” for optimal correction. Therefore, we prefer Anterior Scoliosis Correction (ASC) and not VBT (Vertebral Body Tethering). For this and many of the reasons listed on this page, Drs. Antonacci, Dr. Betz, and Dr. Cuddihy, who are pioneers in this field, prefer ASC. Furthermore, it is the opinion of Drs. ABC that ASC yields aesthetically appealing cosmetic incisions hidden under the arms better than VBT.
|Curve 40-65 degrees||Yes||Yes|
|Curves over 65 degrees||Yes||No|
|*uniquely pioneered by Drs. ABC|
Our candidates for muscle sparing, less invasive scoliosis surgery correction have a variety of scoliosis types. Most have idiopathic scoliosis (adolescent, juvenile, or some forms of adult), or idiopathic “like” (i.e., post-syrinx decompression). But we have also treated patients whose scoliosis is associated with a syndrome, a neuromuscular condition or is congenital. Each case is individually evaluated and carefully considered. Most are at least 10 years of age, with or without remaining spine growth; have a thoracic, thoracolumbar or lumbar curve(s) of 30 to 80 degrees (some higher at the time of actual surgery).
Dr. Antonacci’s Anterior Scoliosis Correction uses “growth modulation” and “remodeling”– partially restraining one side of the spine to allow growth and remodeling on the other side – to reverse the abnormal scoliosis growth pattern in the anterior thoracic (upper) spine in a less invasive surgery. Titanium pedicle screws are placed on the convexity (outside) of the vertebrae that are causing the scoliosis; a a rod-cord ( white polyethylene-terephthalate flexible cord) is attached to each of the bone screws in the vertebral bodies of the spine. When the implants are tightened, it corrects and straightens the spine. The affected curve(s) show an immediate improvement right after surgery, and continued improvement over time as the spine remodels.
Orthodontists have shown that adult teeth can be realigned and jaw bones can remodel over time using orthodontic braces. In a similar way, we believe mature vertebrae can be realigned using Anterior Scoliosis Correction (ASC) in mature adolescents and adults. Once the asymmetric pressure of the curve is removed and the spine is held in a more normal position, the vertebrae and disks can remodel to maintain this correction over time. The key is to do ALL of the desired 3-dimensional spine correction at the time of surgery – meaning to straighten the ‘S’ curve itself, de-rotate the rotated vertebrae, and restore the spine’s (sagittal) postural curvatures that are often absent in scoliosis. To achieve this, our team has added some additional, advanced, corrective techniques to the procedure which may be needed if the mature curves are not completely flexible.
We have achieved dramatic curve corrections in stiff and high degree curves not elsewhere obtained. This is because we have pioneered advanced corrective techniques tailored to the individual situation. We really do not have criteria of exclusion from this treatment like many other centers .Each case must be carefully evaluated individually and we will recommend options.
Typically surgery that is less invasive will carry less risk for the patient for several reasons. This is the case using of Dr. Antonacci’s Anterior Scoliosis Correction. The spine can continue to move and bend, so the patient may experience less discomfort and more freedom of movement. We achieve this by using a muscle-sparing approach so unlike traditional invasive back surgery, no back muscles are cut, and there is minimal disruption and much faster healing. Additionally blood loss is very low using these less invasive techniques. Recovery therefore averages about 4 weeks, with return to unrestricted activity at 6 weeks in most cases.
This map shows a world-view of the hundreds of cases of ASC by Drs. ABC. All of the locations are general and do not include any personal information. Privacy is our main focus over accuracy. Locations may be in a generic spot, this includes public areas such as parks, business districts, or waterways.
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