What is vertebral stapling?
Vertebral stapling is a novel surgical technique that may prevent the curve progression in children and adolescents diagnosed with moderate scoliosis.
A minimally invasive procedure, stapling may be an alternative to bracing for some patients who are at risk for progression of the scoliosis and the prospect of spinal fusion in their future. Surgeons, through the aid of an endoscopic camera, insert special staples, made of titanium alloy, along the outer (convex) curve of the spine to help stabilize and prevent further progression of the curve.
How does vertebral stapling work?
Recent advancements in technology have lead to the development of staples that are made from a Nitinol – a shaped memory alloy. Comprised of nickel and titanium, these staples are pliable when exposed to cooler temperatures. This special material allows the staples to hold one shape when cool and another shape when warm (figure 1)
By placing the staples in an ice tray prior to insertion (figure 2) the surgeon is able to straighten the staple – making it easier to insert along the spinal curve. When warmed by body temperature the staples are then able to return to their original crimped shape.
Who are ideal candidates for vertebral stapling?
Ideal candidates for this procedure are children and adolescents between the ages of 8-15, who are still growing (have not reached skeletal maturity) and are seeking an alternative to wearing a spinal brace. The child should have a moderate spinal curve, between 25-40°, and present a risk for curve progression. Patients should also have no major kyphosis.
Benefits of this minimally invasive procedure over more traditional surgical methods (open surgery) such as spinal fusion – include the use of fewer and smaller incisions. This relatively new approach allows the child to recuperate faster and with less pain. Vertebral stapling also eliminates the need of a spinal brace. With the absence of a spinal brace children and adolescents may be able to participate more actively in sports and other activities.
In addition, the stapling procedure maintains some of the natural spine motion, which is lost during the spinal fusion procedure.
Vertebral stapling is not an ideal procedure for all children. Children or adolescents who have reached skeletal maturity, or those with stiff or large spinal curves will not benefit from this procedure. Further surgery may also be needed if vertebral stapling is not successful in stopping the progression of the spinal curve. As with other innovative surgical procedures there is a limited amount of clinical data available. The long-term outcome for this procedure is unknown. As this is a relatively new and novel procedure it may not be covered by insurance.