Vertebral body stapling is an effective treatment for pediatric patients with scoliosis. The procedure involves placing metal staples between two vertebral bodies to squeeze the growth plates and help straighten the spine.
How the procedure works
All bones grow with the child. This procedure works by slowing the growth of one part of the spine, which allows the opposite side to continue growing. This can prevent worsening of the deformity and in some cases improve the deformity.
How the surgery is performed
The surgery uses small incisions through the side of the chest to allow the surgeons to place the staples. The chilled staple assumes a "u" shape, is inserted spanning the two vertebral bodies, and when it is warmed by body temperature, assumes a "c" shape, which grabs the two vertebral bodies and squeezes them together. Typically, six - seven staples are used during the procedure. The surgery takes about three hours to perform.
A small chest tube is inserted and removed one - two days after surgery. The child is typically home after three - four days. The child can return to school in about two - three weeks. The child should not engage in sporting activities for three months.
Ideal candidates for surgery
Success of this procedure is defined by either no continued increase in deformity, or an improvement in overall spine shape. Younger children typically see better results because they have several years of physical growth remaining, as well as through whose spines are not excessively rounded.
There are risks with every form of surgery, and most of the risks associated with vertebral body stapling are manageable. The risks include:
Bleeding requiring a large incision to control
Upper bowel obstruction
Possibility of staple breaking or backing out (very rare)
Loss of sagittal contour
Infection (less than 1 - 100 chance)
Neurological loss ( This has never been reported, but we always use neural monitoring during surgery to ensure the highest degree of safety.)