An innovative vertebral body tethering (VBT) system provides an option to treat pediatric scoliosis with a non-fusion, dynamic approach.

The Auctus Surgical (San Francisco, CA, USA) dynamic VBT system is based on a bone anchor with a cleat mechanism that is screwed into each vertebra. A flexible tether is passed through the anchors on multiple vertebrae and is spooled on a tensioning unit, which can then be activated to correct the spinal deformity. The tension in the flexible tether is adjusted using a remotely driven actuator that is controlled via an external magnetic controller, which provides for non-surgical adjustment of the spinal curvature over time.

Benefits of the system include a single treatment event for placement of the bone anchors, tether, and tension mechanism, with no further surgical intervention; maintaining uninterrupted, continued skeletal growth; partial motion preservation; little impact on both the activity and appearance of the child; gradual adjustment over time; and since fusion is not part of the treatment plan, the dynamic VBT system does not ‘burn any bridges’, allowing future spinal fusion to remain as an unimpacted option, if VBT fails.

“Necessitating only one treatment event, the Auctus System utilizes an external magnet controller for non-surgical adjustment of the spinal curvature over time in order to give adolescents a viable, flexible option to complex fusion surgery,” said John Barrett, CEO and founder of Auctus Surgical. “I am proud of the tremendous efforts put forth by our team, efforts that will make a concrete difference in the lives of suffering adolescents and their families.”

“Spinal fusion for scoliosis is a century old operation that corrects deformity, but eliminates movement of the spine. The pediatric surgical community, as well as our patients, are eager for and welcoming of a fusionless option for the treatment of scoliosis,” said Professor Mohammad Diab, MD, of the department of orthopaedic surgery and the department of pediatrics at the University of California San Francisco (UCSF; USA). “The Auctus Dynamic Tethering System will do just that and will do so in a modular manner that allows greater control of the spine.”

Idiopathic scoliosis is the most common spinal deformity in children, causing a sideways curvature of the spine whose cause is unknown. Standard treatments for idiopathic scoliosis among children and adolescents who are still growing are conservative, non-surgical treatments such as external bracing to help correct the spinal curvature, and VBT. For patients who do not respond to bracing, spinal fusion surgery may be used to stabilize and correct spinal curvatures, but restricts spine motion and incurs long-term complications such as pain, arthritis, and potential spinal deformities. 

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