Lived Experiences of Vertebral Body Tethering: A Qualitative Study of the Patient Journey.

Abstract

Purpose: Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity in children. While posterior spinal fusion is the standard treatment for curves ≥45°, anterior vertebral body tethering (VBT) has emerged as an alternative for some patients. This study explores the experiences of patients who underwent VBT, focusing on decision-making, recovery, and long-term concerns.

Patients and methods: Semi-structured interviews were conducted with twenty patients diagnosed with progressive AIS and a spinal deformity less than 60° at the time of surgery. All participants underwent VBT, completed three years of follow-up, and had reached skeletal maturity. Recruited from a single orthopaedic institute and treated by the same physician, participants averaged 18 years of age, 85% were women. Interview transcripts were analyzed using collaborative content analysis.

Results: Key decision-making factors included pain, worsening condition, brace use, and concerns about appearance. VBT was preferred over fusion due to perceived benefits such as preserved flexibility, less invasiveness, shorter recovery, and lower risk of infection. Decisions were also influenced by family, physicians, and experiences of others. Recovery experiences were mixed. Some participants described difficult early recovery but felt positive overall; others recalled prolonged pain and physical limitations. Most reported reduced anxiety post-surgery, though concerns about long-term effects and future surgeries remained.

Conclusion: This study offers insight into the lived experience of individuals who underwent VBT and underscores the importance of patient-centered care in surgical decision-making and recovery. Findings highlight opportunities to support patients considering VBT versus fusion and the need for comparative effectiveness studies focused on long-term outcomes and quality of life.