Vertebral Body Stapling and Vertebral Body Tethering for the Treatment of Scoliosis

This policy addresses vertebral body stapling (VBS) and vertebral body tethering (VBT) as fusion‑less, growth‑modulating surgical options for skeletally immature patients with progressive adolescent idiopathic scoliosis—typically those with curves at high risk of progression (roughly 25°–40° for VBS and about 30°–65° for VBT), especially after failed or intolerant bracing and when radiographs show adequate osseous anatomy for fixation. These procedures are considered experimental/investigational and not covered by the payer, are limited to specific FDA HDE populations, are not indicated for skeletally mature patients or curves outside the recommended ranges, and have limited long‑term evidence (including uncertain optimal tether tensioning).

"Adolescent idiopathic scoliosis: lateral curvature of the spine with onset at ≥10 years of age and no underlying etiology, with risk for progression during puberty"