Dr. Michelle Welborn, Vertebral Body Tethering & Research on Growth Potential by Dr. Derek Lee

This interview is for educational purposes and covers information provided by Dr. Michelle Welborn regarding her opinions on Vertebral Body Tethering (VBT) and research on a biomarker for measuring growth status and potential. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
0:20 Career path to orthopedic surgeon.
3:53 Early interest in pediatrics.
5:25 Perspective on Shriners Hospital for Children. Rare diseases, research and support.
7:16 Research, education and physician pediatrics training at Shriners Hospitals for Children.
10:33 Dr. Welborn's biomarker research to measure real-time growth status and growth velocity.
11:42 What was the catalyst for Dr. Welborn's research?
12:07 Growth today is based on the "average" person.
12:49 X-rays cannot predict growth potential.
13:17 Growth potential matters vs. skeletal maturity.
13:36 Changes approach to VBT and bracing.
14:20 The origin of Dr. Welborn's growth status research.
14:55 Collagen-X biomarker: measurable when soft bone turns into hard bone at growth plate.
15:35 Technology and measurement of collagen-x biomarker.
16:46 Instantaneous real time measurement of growth velocity.
17:20 Dr. Welborn took on the task of proving this instantaneous measure of growth works.
18:34 Importance of proving the test in different ethnic populations and genders.
18:43 Test will reveal if a child will be tall or short and if child is an early or late bloomer.
19:27 Data indicates that the test is much more accurate that x-ray measurements of growth.
19:37 Cessation of growth can now be measured accurately.
21:08 Development of the test to real world application.
23:01 Simple finger stick test.
25:11 What information does the test tell doctor's immediately?
27:33 Predicting height.
28:36 Comparing accuracy of the collagen-x test vs x-ray bone maturity classification.
29:22 Collagen-x test potential impact on Vertebral Body Tethering surgical decision making.
32:33 Dr. Welborn must wait for proof that the biomarker test works before using it clinically.
33:53 Research is also tracking curve progression at different stages of growth and bracing.
35:30 Curve progression post-bracing and exercise.
36: 32 First exposure to VBT and first surgery.
40:23 Dr. Welborn's VBT parameters.
44:06 Factors that determine possible final curve correction.
44:53 Research indicates 44-45% VBT curve correction at 2 years.
47:32 Should tethers be tensioned more at time of surgery?
49:05 Disc release.
51:56 Lumbar single and double tethers.
53:54 Activity post-tethering.
55:51 Perspective on new tether technology.
58:13 Perspective on the future of scoliosis treatment.
drdereklee.com
/ 1198200727630801

[@DerekLee]

This interview is for educational purposes and covers information provided by Dr. Michelle Welborn regarding her opinions on Vertebral Body Tethering (VBT) and research on a biomarker for measuring growth status and potential. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters:
0:00 Introduction
0:20 Career path to orthopedic surgeon.
3:53 Early interest in pediatrics.
5:25 Perspective on Shriners Hospital for Children. Rare diseases, research and support.
7:16 Research, education and physician pediatrics training at Shriners Hospitals for Children.
10:33 Dr. Welborn's biomarker research to measure real-time growth status and growth velocity.
11:42 What was the catalyst for Dr. Welborn's research?
12:07 Growth today is based on the "average" person.
12:49 X-rays cannot predict growth potential.
13:17 Growth potential matters vs. skeletal maturity.
13:36 Changes approach to VBT and bracing.
14:20 The origin of Dr. Welborn's growth status research.
14:55 Collagen-X biomarker: measurable when soft bone turns into hard bone at growth plate.
15:35 Technology and measurement of collagen-x biomarker.
16:46 Instantaneous real time measurement of growth velocity.
17:20 Dr. Welborn took on the task of proving this instantaneous measure of growth works.
18:34 Importance of proving the test in different ethnic populations and genders.
18:43 Test will reveal if a child will be tall or short and if child is an early or late bloomer.
19:27 Data indicates that the test is much more accurate that x-ray measurements of growth.
19:37 Cessation of growth can now be measured accurately.
21:08 Development of the test to real world application.
23:01 Simple finger stick test.
25:11 What information does the test tell doctor's immediately?
27:33 Predicting height.
28:36 Comparing accuracy of the collagen-x test vs x-ray bone maturity classification.
29:22 Collagen-x test potential impact on Vertebral Body Tethering surgical decision making.
32:33 Dr. Welborn must wait for proof that the biomarker test works before using it clinically.
33:53 Research is also tracking curve progression at different stages of growth and bracing.
35:30 Curve progression post-bracing and exercise.
36: 32 First exposure to VBT and first surgery.
40:23 Dr. Welborn's VBT parameters.
44:06 Factors that determine possible final curve correction.
44:53 Research indicates 44-45% VBT curve correction at 2 years.
47:32 Should tethers be tensioned more at time of surgery?
49:05 Disc release.
51:56 Lumbar single and double tethers.
53:54 Activity post-tethering.
55:51 Perspective on new tether technology.
58:13 Perspective on the future of scoliosis treatment.
drdereklee.com
Facebook VBT/ASC/Tethering Support Groups:
Canada: facebook.com/groups/60224...
USA: facebook.com/groups/Scoli...
UK: facebook.com/groups/12878...

[@haideewebb8380]

Fantastic videos. I am the parent of a 14 yo boy in Canada who has been bracing for 8 months now. Unfortunately his curves have progressed and it looks like surgery is on the horizon. It's very helpful to distinguish between skeletal maturity and growth potential. I wonder if there has been any progress in the biomarker research and if it will soon become widely available. Thanks again. These videos are all so very interesting.

[@DerekLee]

The biomarker process is solid and proven. It just has to go through FDA approval which will probably take another 1.5-2 years. But, it will dramatically impact all orthopedics related to children.
If you have watched the videos on non-fusion surgical options, VBT/ASC, you may have noted that some surgeons have wider parameters and accept larger curves. Being in Canada, you'll have to travel out of country for said surgeons.

[@DerekLee]

Also, much thanks for your kind words. :)