During the tethering procedure, Dr. Lowenstein, director of Scoliosis and Spine Deformity at Morristown Medical Center, works closely with fellowship-trained thoracic surgeon and thoracic surgical oncologist Federico A. Steiner, MD, 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,” said Dr. Lowenstein. “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.”
Dr. 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.
Dr. Lowenstein added: “Patients who have had the tether procedure are doing great. 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.”
“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,” said James C. Wittig, MD, chairman of the Department of Orthopedics at Morristown Medical Center and medical director, Orthopedic Oncology, Atlantic Health System. “We are proud to be the first to combine these two technologies to help children and teens live more normal lives.”
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.
“Airo TruCT is made for complex spine surgery,” said Dr. Lowenstein. “In my opinion, it is significantly more accurate than other intraoperative imaging systems that are currently available. This allows for safer and faster guidance when I’m placing my spinal instrumentation. Combined with thorascopic videography, we get the best possible images that enable the best outcomes.”
“Providing a minimally invasive thoracoscopic approach in combination with advanced intraoperative imaging in collaboration with Dr. Lowenstein should result in less postoperative pain and quicker recovery time when compared to more conventional techniques,” said Dr. Steiner.
Scoliosis is an abnormal lateral curvature of the spine. It is most often diagnosed in childhood or early adolescence. If left untreated, over time scoliosis can cause pain and various other health problems. Scoliosis affects six to nine million Americans.
Dr. Lowenstein concluded: “Vertebral Body Tethering is changing the way we treat patients with scoliosis. It is used primarily for skeletally immature children, but there is some increasing evidence that, in the future, tethering may play a role in treating older pediatric patients or even adults. It differs from the gold standard of scoliosis surgery, spinal fusion, by retaining motion across the levels that are surgically being treated, which offers both short term advantages (faster recovery time and return to normal activities, increased flexibility that allows for better participation in athletic activities) and also long term decreased risk of developing degeneration of the spine above or below a spinal fusion.”
About Atlantic Health System
Atlantic Health System is at the forefront of medicine, setting standards for quality health care in New Jersey, Pennsylvania and the New York metropolitan area. Powered by a workforce of more than 18,000 team members and 4,800 affiliated physicians dedicated to building healthier communities, Atlantic Health System serves more than half of the state of New Jersey including 11 counties and 4.9 million people. The not-for-profit system offers more than 400 sites of care, including seven hospitals: Morristown Medical Center in Morristown, NJ, Overlook Medical Center in Summit, NJ, Newton Medical Center in Newton NJ, Chilton Medical Center in Pompton Plains, NJ, Hackettstown Medical Center in Hackettstown, NJ, Goryeb Children’s Hospital in Morristown, NJ, and Atlantic Rehabilitation Institute in Madison, NJ.
Atlantic Medical Group, comprised of 1,000 physicians and advanced practice providers, represents one of the largest multi-specialty practices in New Jersey and joins Atlantic Accountable Care Organization and Optimus Healthcare Partners as part of Atlantic Alliance, a Clinically Integrated Network of more than 2,500 health care providers throughout northern and central NJ.
Atlantic Health System provides care for the full continuum of health care needs through 16 urgent care centers, Atlantic Visiting Nurse and Atlantic Anywhere Virtual Visits. Facilitating the connection between these services on both land and air is the transportation fleet of Atlantic Mobile Health.
Atlantic Health System leads the Healthcare Transformation Consortium, a partnership of six regional hospitals and health systems dedicated to improving access and affordability and is a founding member of the PIER Consortium – Partners in Innovation, Education, and Research – a streamlined clinical trial system that will expand access to groundbreaking research across five health systems in the region.
Atlantic Health System has a medical school affiliation with Thomas Jefferson University and is home to the regional campus of the Sidney Kimmel Medical College at Morristown and Overlook Medical Centers and is the official health care partner of the New York Jets.