Tethering for scoliosis is a newer, minimally invasive surgery that works with a child’s natural growth process to correct their spinal curvature over time.

Published: August 8, 2022 | Updated: August 9, 2022

Tethering for scoliosis is a newer, minimally invasive surgery that works with a child’s natural growth process to correct their spinal curvature over time. 

Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine, offers the latest pediatric scoliosis tethering technology.

“Tethering is a newer technique that corrects a child’s scoliosis, but unlike a spinal fusion surgery, tethering allows a child to maintain their mobility as they grow up and later in life,” said Kent L. Walker, D.O., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville.

During a tethering surgery, several screws and a tether are placed along the spinal curvature. As a child grows, the tether will guide the spine into straightening. Surgeons perform the procedure by making small incisions and using an endoscopic camera.

Benefits of tethering for scoliosis

Tethering for scoliosis involves a variety of benefits for the patient, compared with a spinal fusion surgery. The tether works in tandem with a child’s natural spinal growth, which allows for additional mobility and flexibility of the spine. Children also may participate in sports and other activities with fewer restrictions after recovery — or none. The surgery is minimally invasive and requires less downtime. Children can return to school within a couple of weeks and resume their normal activities within a few months.

Tethering should be performed when a child’s spine is still growing, usually between the ages of 10 and 15. It can be performed in the upper back (thoracic spine) or lower back (lumbar spine).

Latest technology and treatments available

The ApiFix procedure, which was approved by the Food and Drug Administration in 2019, is the latest treatment option for scoliosis and is available at Norton Children’s Orthopedics of Louisville. 

ApiFix is not tethering, but another fusionless technique that is less invasive than standard scoliosis surgery. The ApiFix device is a mobile rod-like device that does not fuse the spine and can be used in both kids that are actively growing as well as those who are skeletally mature. This can be an alternative to traditional spine fusions in someone who is done growing.

ApiFix differs from traditional tethering based on its approach, according to Joshua W. Meier, M.D., pediatric orthopedic surgeon at Norton Children’s Orthopedics of Louisville, who performs this type of procedure. ApiFix uses a posterior approach, which differs from the lateral approach used in tethering.

The ApiFix procedure is available for patients with adolescent idiopathic scoliosis with single curves measuring 35 degrees to 60 degrees.