Vertebral Body Tethering (VBT) Surgery in Turkey

What Is Vertebral Body Tethering (VBT)?

Vertebral Body Tethering (VBT) is a modern, growth-friendly surgical option for adolescents with idiopathic scoliosis who are still growing. Unlike traditional spinal fusion, which permanently joins sections of the spine, VBT uses a strong but flexible cord to guide the spine into a straighter position as your child grows—helping preserve natural movement and flexibility.

Many families consider VBT so their child can continue activities they love, such as swimming, gymnastics, or dance, without permanently restricting spinal motion.

Who May Be a Candidate for VBT?

VBT may be considered for children and adolescents who:

• Are still growing
• Have idiopathic scoliosis with a moderate spinal curve
• Show sufficient curve flexibility on imaging
• Have bone quality suitable for secure implant placement

However, VBT is not suitable for every scoliosis patient. Children who are fully grown, have weak bone density, active infection, prior surgery at the affected spinal levels, or certain medical conditions may not be candidates.

A definitive decision can only be made after careful review of X-rays and clinical evaluation by an experienced spine surgeon.

Understanding the Procedure in Simple Terms

During VBT surgery, small incisions are made along the side of the chest. Titanium screws are placed into the vertebrae along the outer edge of the curve, and a flexible medical-grade cord is gently tensioned between them. Over time, as your child grows, this controlled tension helps guide the spine into a straighter alignment—without permanently locking it in place.

Because growth plays an essential role in correction, ongoing follow-up is an important part of treatment until skeletal maturity is reached.

Benefits to Consider

Compared with traditional spinal fusion, VBT may offer:

• Preservation of spinal movement
• Smaller incisions and reduced muscle disruption
• A quicker return to everyday activities for many patients
• Avoidance of permanent fusion in appropriately selected cases

It is important to understand that VBT is a newer technique than fusion, and long-term outcomes continue to be monitored as patients reach adulthood.

Possible Risks and Considerations

All surgical procedures carry risks, and VBT is no exception. Possible complications may include:

• Too much or too little correction of the curve
• Loss of correction as growth continues
• Tether or implant wear, loosening, or breakage
• Development of new curves above or below the treated area
• Lung-related complications associated with chest surgery
• Infection, bleeding, nerve irritation, or anesthesia-related risks

In some cases, additional surgery may be required in the future, including revision of the tether or conversion to spinal fusion. Your surgeon will discuss these possibilities in detail so your family can make a fully informed decision.

Recovery, Activity, and Long-Term Outlook

Recovery after VBT varies from child to child. Many patients are able to return to school and light daily activities relatively quickly, with a gradual return to sports and physical activity over time.

All activity milestones must be approved by the treating physician, based on healing progress and follow-up imaging. While many children return to an active lifestyle, no specific level of correction or long-term activity outcome can be guaranteed.

Regular follow-up appointments are essential to monitor spinal growth and ensure the best possible long-term result.

A Note on Costs and Travel Arrangements

Any quoted prices or treatment packages are indicative and may change depending on individual medical findings and surgical needs. Non-medical services such as accommodation, airport transfers, or concierge support are provided for convenience and are separate from the medical treatment itself.

Frequently Asked Questions About Vertebral Body Tethering (VBT)

What is scoliosis, and why does it need treatment?

Scoliosis is a condition where the spine curves sideways, often forming an "S" or "C" shape when seen on an X-ray. In many children, especially those who are still growing, the curve can gradually worsen over time.

If left untreated, progressive scoliosis may lead to visible imbalance, back discomfort, and in more severe cases, reduced lung capacity. Treatment aims to stop curve progression and improve spinal alignment, helping children stay healthy and active as they grow.

How is VBT different from traditional spinal fusion?

Traditional spinal fusion corrects scoliosis by permanently joining sections of the spine using rigid rods and bone grafts. While effective, this limits movement in the fused area.

VBT, on the other hand, uses a flexible cord to guide spinal growth. The spine is not fused, allowing it to retain movement at the treated levels. Because VBT relies on growth, it is only suitable for children and adolescents who still have growth remaining.

Who is VBT intended for?

VBT is intended for skeletally immature children and teenagers with progressive idiopathic scoliosis who meet specific medical criteria. It is generally considered when:

• The spinal curve is moderate in size
• The curve is flexible
• The patient still has significant growth remaining
• Bracing has not been effective or cannot be tolerated

Only a spine specialist can determine suitability after reviewing imaging and clinical findings.

Is VBT an approved and safe procedure?

The device used for VBT is classified as a Humanitarian Use Device (HUD). This designation allows its use in specific scoliosis cases where traditional options may not be ideal.

Clinical experience suggests that VBT can be beneficial for appropriately selected patients, but the effectiveness of the device for its intended indication has not been formally established. As with all surgical treatments, careful patient selection and long-term follow-up are essential.

How long does recovery take after VBT surgery?

Recovery varies from child to child. Most patients spend several days in hospital and continue recovering at home over the following weeks.

Pain medication is usually required for a short period, often one to two weeks. Many children return to school within a few weeks, depending on comfort and medical advice. Your surgeon will provide personalised guidance based on your child's progress.

How active can my child be after VBT?

Activity levels increase gradually after surgery. Light daily activities are usually encouraged early, while sports and more demanding physical activities are reintroduced over time.

Return to sports or exercise must be approved by the treating physician. Healing speed, spinal growth, and follow-up imaging all play a role in determining when activities can safely resume.

When can my child return to school?

Many children return to school approximately two to four weeks after surgery, depending on recovery and comfort. This timeline can vary, and your doctor will advise what is appropriate for your child.

What if my child has pain after surgery?

Some discomfort is normal in the early recovery period. Pain is managed with medication and usually improves steadily. If pain persists or worsens, families are encouraged to contact their medical team for advice.

What are the possible risks of VBT?

As with any surgery, VBT carries potential risks. These may include:

• Over-correction or under-correction of the curve
• Loss of correction as growth continues
• Tether or implant wear, loosening, or breakage
• Lung-related complications due to chest surgery
• Infection, bleeding, nerve irritation, or anesthesia-related risks

In some cases, additional surgery may be needed in the future. Your surgeon will discuss these risks in detail so you can make an informed decision.

What happens if the tether breaks or loosens?

In some cases, a tether may loosen or break over time. If the spinal curve remains stable, no further treatment may be needed. If the curve worsens, revision surgery or an alternative treatment—such as spinal fusion—may be recommended.

Can my child walk through airport security or metal detectors?

Yes. The implants used in VBT are typically made from titanium, which does not usually trigger airport metal detectors. Your medical team can provide documentation if needed for travel.

Is long-term follow-up required after VBT?

Yes. Because VBT works in combination with growth, regular follow-up appointments and imaging are essential until skeletal maturity is reached. This allows the medical team to monitor correction and address any changes early.

How much does VBT surgery cost in Turkey?

The cost of VBT surgery in Turkey is generally significantly lower than self-pay prices in the UK or United States, while maintaining internationally recognised medical standards.

As a reference, an all-inclusive treatment package may be offered in the region of €xxxx / USD xxxxxx, which typically includes hospital care, surgeon and anesthesia fees, and associated services.

Final pricing can vary depending on individual medical findings and surgical requirements, and a personalised quote is always provided after clinical review.

Will my child feel the screws when bending or moving?

In most cases, children do not feel the screws during normal movement. The screw heads are designed to sit flush with the vertebral body and are covered by surrounding tissues.

Some awareness or mild discomfort can occur during the early healing phase, but this typically improves as recovery progresses. Persistent discomfort should always be discussed with the medical team.

Is VBT FDA-approved?

The tether system used for VBT is approved by the U.S. Food and Drug Administration (FDA) under a Humanitarian Device Exemption (HDE) for the treatment of adolescent idiopathic scoliosis in skeletally immature patients.

In Turkey, the use of this device is regulated and licensed by the Turkish Ministry of Health, following standards that align with international regulatory frameworks. As with all medical devices, use is limited to specific indications and patient criteria.

Final Note for Families

Every child's spine, growth pattern, and recovery journey is unique. The goal of VBT is to offer a motion-preserving option for carefully selected patients, but no single treatment is right for everyone.

A detailed consultation with a qualified spine specialist is the best way to understand which treatment option is most appropriate for your child.