Surgeons at Morristown Medical Center are the first team in New Jersey to use a new, FDA-approved tethering system for minimally invasive scoliosis surgery that provides for flexible spinal deformity correction and faster healing.
The team, led by Dr. Jason Lowenstein, also is the first in the nation to use a new type of portable CT scanner to guide the procedure and actually “see” inside the spinal canal during the surgery using Stryker’s SpineMap 3D in conjunction with the tether.
Lowenstein, a fellowship-trained scoliosis surgeon, is the director of scoliosis and spine deformity at Morristown Medical Center.
During the tethering procedure, Lowenstein works closely with fellowship-trained thoracic surgeon and thoracic surgical oncologist Dr. Federico Steiner, who helps obtain real-time images from inside the body with the new CT scanner, as the screws that anchor the tether are attached.
“The difference between the effects of a spinal fusion and a tether is flexibility,” Lowenstein said. “Long term, the patient will have a greater range of motion, will potentially be able to participate in strenuous sports activities throughout their lifetime, with less risk of having to worry about correcting degenerative changes down the road.”
Lowenstein is using Zimmer Biomet’s Vertebral Body Tethering System — the only spinal tethering system approved by the FDA for this use.
The tether — a strong, flexible cord — straightens patients’ spines using their own growth process. This is called “growth modulation.” The tether is the only medical device available that treats scoliosis while patients are actively growing and uses their own growth to repair the curve in their spines. The tether puts pressure on the outside of the spinal curve, allowing the inside of the curve to continue growing. This is what straightens out the spine.
Besides the tether, which is a new treatment option for many pediatric patients, scoliosis is often treated by using a back brace for milder curves, or when they progress or become severe, spinal fusion becomes necessary to correct the deformity.
The procedure is done minimally invasively, placing a tiny thorascopic camera into the chest through a small incision in order to visualize the spine on a video monitor, and then using Stryker’s Airo TruCT Mobile Imaging system to obtain a true CT scan of the patient during the surgery.
Using these images as well as direct thorascopic camera visualization, screws are placed into the spine using real-time CT guided navigation, to allow for the screws to be safely and accurately placed into the spine. The flexible tether is then placed and its tension adjusted to allow for flexible correction of the patient’s scoliosis.
Lowenstein said the procedure has been a success.
“Patients who have had the tether procedure are doing great,” he said. “It allows for a faster recovery than spinal fusion, because patients aren’t waiting for the fusion to heal. And, because it is a minimally invasive surgery, there is less soft tissue dissection, again allowing for less time to heal.”
Dr. James Wittig, chairman of the Department of Orthopedics at Morristown Medical Center and medical director, orthopedic oncology, Atlantic Health System, said the benefits are enormous.
“At Atlantic Health System, we are committed to using the latest FDA-approved technologies for the benefit of our patients in order to provide them with the safest procedures, best quality of life and most outstanding evidence-based outcomes,” he said. “We are proud to be the first to combine these two technologies to help children and teens live more normal lives.”