Dr. Per Trobisch, 500 VBT Surgeries Lessons Learned, Hybrid VBT with Apical Fusion Scoliosis Surgery

This interview is for educational purposes and covers information provided by Dr. Per Trobisch regarding his opinions on Vertebral Body Tethering (VBT) Non-Fusion Scoliosis Surgery. This video is not an endorsement. Viewers should consult their physicians and treating team accordingly. See highlights via timestamps below.
Chapters
00:00 Introduction
1:30 Surgical screening 5 scoliosis curve types. When to use VBT vs Fusion.
8:22 Perspective on VBT for sagittal alignment of the spine.
10:51 Ideal Candidates for VBT.
11:21 Case 1: Lumbar VBT, single tether (Sanders 5).
16:50 Are 2 tethers better than 1 tether?
19:16 Biomechanical testing of single & double tethers.
21:32 Case 2: Lumbar VBT, double tether (Sanders 7).
23:59 Perspective on triple and quad tethers.
25:38 New larger stronger tethers.
27:00 Tether breakage does not mean failure.
27:28 Case 3A: Lumbar VBT, double tether failure.
31:30 Finding tether breaks on x-ray.
32:51 Analysis of tether breakage post revision surgery.
33:30 Posterior tether breaks 1st followed by anterior tether.
34:17 Tether breakage occurs between screws at disc level.
35:29 Where do tethers break the most often?
36:03 Rotation at curve apex can place more tension on flexible ends of tether span.
37:24 Biomechanics of tether breaks are different in vivo vs in a lab.
38:29 Case 3B: Lumbar VBT, double tether failure with revision.
39:54 Case 3C: Lumbar revision hybrid VBT with 2 level apical fusion.
41:00 How to determine which levels to fuse with this hybrid VBT apical fusion technique?
42:33 Case 4: Double curve hybrid VBT with apical fusion (Sanders 3).
46:12 For hybrid VBT with apical fusion, will the fusion hold without rods and screws?
47:55 Is hybrid VBT with apical fusion an option for more mature scoliosis cases?
50:00 Is hybrid VBT with apical fusion an option for thoracic curves?
50:55 Dr. Trobisch's pediatric vs adult disc maturity hypothesis.
57:04 The future of Vertebral Body Tethering (VBT).
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