Making the Case for Vertebral Body Tethering: What's the Evidence?

Vertebral body tethering (VBT) is a growth-modulating, motion-preserving surgical alternative to posterior spinal fusion for select patients with adolescent idiopathic scoliosis. This review critically appraises the current evidence surrounding VBT, including surgical indications, technical considerations, radiographic and functional outcomes, and comparative data versus fusion and emphasizes patient selection based on skeletal maturity. The article also explores emerging applications in skeletally mature and non-idiopathic populations and highlights ongoing innovations in implant design and predictive modeling. Standardization in reporting and the need for long-term outcome data are identified as key areas for future development to define VBT's role in modern scoliosis care.