Dubai Hospital performs first Vertebral Body Tethering surgery in Middle East
7 July 2022 14:15

Dubai Hospital performs first Vertebral Body Tethering surgery in Middle East

DUBAI. KAZINFORM - In a unique medical accomplishment for the UAE, the MENA region’s first Vertebral Body Tethering (VBT) surgery has been successfully performed at a Dubai hospital. The minimally invasive surgery was carried out last week on a 13-year-old Jordanian girl with adolescent idiopathic scoliosis at Burjeel Hospital, Dubai, WAM reports.

Salma Naser Nawayseh’s parents first noticed the curve in her spine in April 2022. They were stunned when doctors diagnosed her with scoliosis, a condition in which there is an abnormal lateral curve of the spine. Scoliosis can develop in infancy or early childhood. However, the primary age of onset for scoliosis is 10-15 years, occurring equally among both genders.

While scoliosis affects 2-3 percent of the population, most cases are mild and do not require invasive treatment. If left untreated, moderate to severe scoliosis can lead to pain, increasing deformity, and potential heart and lung problems. Corrective surgery is essential in cases like Salma’s, where the patients have large curves.

After consulting many doctors in the UAE, Salma’s parents approached Dr. Firas M. Husban, Consultant Orthopedic Surgeon, at Burjeel Hospital for a permanent solution. According to Dr. Husban, when Salma, a grade 9 student, came to him, she had a thoracolumbar curve of 65 degrees. Due to her condition, she suffered deformity of the back with shortening of the trunk, lower back hump, unlevelled pelvis, and back pain.

«Adolescent idiopathic scoliosis is the most common type and is usually diagnosed during puberty. The three treatment options for such patients are observation, bracing, or surgery. While bracing is an option in patients with mild forms of scoliosis, in Salma’s case, she required surgery to correct the deformity,» said Dr. Husban, who informed Salma’s parents of a new minimally invasive treatment for scoliosis.

The traditional option to correct scoliosis is spinal fusion surgery, where two or more vertebrae are permanently joined into one structure using screws and rods. While spinal fusion is the most common surgery to treat scoliosis, it limits spinal mobility and subsequent growth. In 2019, the United States Food and Drug Administration (USFDA) approved a new treatment called Vertebral Body Tethering (VBT), a minimally invasive technique that allows for continued growth without fusion while preserving motion and flexibility.

The new treatment enables fusionless spine correction, allowing the patient to experience the full range of motion and further growth. Its other advantages include discreet incisions, minimal trauma, fewer complications, and faster healing. As Salma had not reached full skeletal maturity yet, she was the perfect candidate for this procedure.

Explaining the procedure, Dr. Husban said, «As opposed to spinal surgeries that involve cutting into the back and manipulating the spinal cord and nerve roots, in this surgery, we make discreet incisions in the abdomen through the endoscope. A flexible cord, called the tether, is attached to the spine on the outside of the curve through bone screws. Tension is applied to the tether to straighten the spine.

»The tether puts pressure on the outside, allowing the inside of the spinal curve to grow. Because VBT is minimally invasive, there is little trauma to the delicate tissues of your back. As a result, there is less blood loss, less postoperative pain and speedier recovery time compared to the spinal fusion surgery.«

Right after surgery, Salma’s spinal curve shows improvement. According to Dr. Husban, the curve will continue to improve, and the tether will guide the growth of the spine as the body grows.

»The patient is recovering well after the surgery. After two weeks, Salma can go back to school. Four weeks later she can return to full activity with no restrictions and can start playing sports,« he added.

Salma’s parents are thrilled at the outcome. «She started walking the second day after surgery. We are happy that our daughter was eligible for this surgery. We look forward to our daughter holding the racket again and resuming tennis. We thank the medical and non-medical staff at Burjeel Hospital, Dubai, for taking good care of us. We are grateful to Dr. Husban for making this surgery available in our region,« they said.

VBT is currently performed in very few countries, including the US, France, and Germany. This is the first instance of the surgery being performed in the GCC and North Africa.

Not every patient with adolescent idiopathic scoliosis is a candidate for VBT. It would ideally be performed in children and teens in the age group of 9 years and above who are still growing. Moreover, the procedure is most effective in patients with a curve of 45 to 65 degrees.

Despite being a newer treatment, the cost of VBT is similar to other treatments for scoliosis.

»It is a great privilege to conduct the first VBT surgery in the MENA region at Burjeel Hospital, Dubai. The surgery is a testament to the advanced medical capabilities of the UAE. It took months to get the approval and instruments ready for the procedure. We plan to further expand our scoliosis treatment facilities to help affected patients enjoy a better quality of life. We are hopeful that the success of the surgery will inspire people from all over the Middle East to come to the UAE for the procedure,« said Dr. Shajir Gaffar, CEO of VPS Healthcare (Dubai and Northern Emirates).

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Photo: wam.ae

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NUR-SULTAN. KAZINFORM - Globally, the number of weekly cases went down by 9 percent with over 6.5 million cases reported. Cases in Kazakhstan, however, were rising since June 20 before going down steadily over the past three days. More about the epidemiological situation globally and in Kazakhstan is in the latest article of Kazinform.

According to the World Health Organization’s weekly epidemiological update published on August 3, the number of new weekly deaths remained stable between July 25 and July 31, as compared to the previous week, with over 14,000 fatalities reported.

«At the regional level, the number of reported new weekly cases increased in the Western Pacific Region (+20 percent) and the African Region (+5 percent); at the same time, it decreased or remained stable in the European Region (-35 percent), the Eastern Mediterranean Region (-12 percent), the South-East Asia Region (-2 percent) and the Region of the Americas (-2percent). The number of new weekly deaths increased in the Western Pacific Region (+44 percent), the Eastern Mediterranean Region (+26 percent), the South-East Asia Region (+20 percent), and the African Region (+12 percent), while it decreased in the European Region (-26 percent). The number of new weekly deaths in the Region of the Americas was similar to the figure reported during the previous week,» reads the WHO update.

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China, where the first cases of COVID-19 were reported, is now struggling to quell another outbreak. As of August 7, China reported 324 locally transmitted confirmed COVID-19 cases, 259 of them were in Hainan Province, according to the National Health Commission. Altogether 483 local asymptomatic carriers were newly identified on the day.

Among the latest measures, Chinese authorities announced more lockdown measures on its Hainan Island, leaving nearly 80,000 tourists stranded. Public transportation has been suspended and people's movements inside the city were restricted from August 6 morning. The tourists are required to stay for seven days and take five Covid-19 tests before leaving.

All flights have been canceled too.

In other parts of China, lockdown measures are also in place. Its biggest financial and business hub Shanghai has emerged from a two-month strict lockdown in June.

China uses a zero Covid strategy, meaning frequent and mass testing and strict lockdowns. The authorities can rule a lockdown affecting millions of people because of only a handful of cases. The country’s zero COVID strategy, however, has faced significant criticism.

This is what happened in the city of Wuhan on July 28, where the authorities forced residents to stay inside their homes for three days after four asymptomatic COVID-19 cases were detected. Some businesses and public transport were closed with a ban on large group events and dining at restaurants.

At the country level, Japan reported the highest numbers of new weekly cases – 1,379,099 new cases, up by 42 percent. The country is also struggling to address the spike in cases.

In their report as of August 4, the National Institute of Infectious Diseases said nationwide, the number of new cases was about 978 per 100,000 in the last week, continuing to rapidly increase at a ratio of this week to last week of 1.89.

«It is again the highest level of infection ever in Japan, increasing in all age groups. As the number of new cases of infection increases, the number of patients receiving medical treatment continues to increase, and although the use rate of beds shows regional differences, and in some regions, there is a heavy burden on the medical care provision system. In addition, the numbers of severe cases and deaths continue to increase, and attention should be paid to future trends,» reads the report.

Japanese authorities warn the public to stay vigilant as the forecast is that cases might skyrocket. What is interesting in the case of Japan is that the country never mandated people to stay at home or vaccinate. It called on people to avoid travel and non-essential outings and imposed fines on businesses that violated the rule to close early.

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Over the past week, new cases in Europe grew by 29 percent reaching 1,914,599 and the number of deaths rose by 30 percent reaching 4,315.

«Fourteen (23 percent) countries in the region reported increases in new cases of 20 percent or greater, with some of the highest proportional increases observed in Kyrgyzstan (981 vs 88 new cases;+1015 percent), the Republic of Moldova (5793 vs 3360 new cases; +72 percent), and the Russian Federation(69 464 vs 41 959 new cases; +66 percent). The highest numbers of new cases were reported from Germany (459 724 new cases; 552.8 new cases per 100 000; -26 percent), Italy (394 583 new cases; 661.6 new cases per 100 000; -26 percent), and France (290 392 new cases; 446.5 new cases per 100 000; -46 percent),» reads the WHO report.

WHO Regional Director for Europe Dr Hans Henri P. Kluge said the region is in the same situation as last summer. He forecasts the situation may even worsen in the autumn and winter.

«It’s now abundantly clear we’re in a similar situation to last summer – only this time the ongoing COVID-19 wave is being propelled by sub-lineages of the Omicron variant, notably BA.2 and BA.5, with each dominant sub-lineage of Omicron showing clear transmission advantages over the previously circulating viruses. With rising cases, we’re also seeing a rise in hospitalizations, which are only set to increase further in the autumn and winter months as schools reopen, people return from holidays and social mixing moves indoors with the onset of colder weather. This forecast presents a huge challenge to the health workforce in country after country, already under enormous pressure from dealing with unrelenting crises since 2020,» said Dr. Kluge in his July 19 statement.

He urged the governments to increase vaccine uptake in the general population, administer a second booster dose to immunocompromised people aged 5 and above and their close contacts, and consider offering a second booster to specific at-risk groups, at least 3 months after their last dose, promoting mask-wearing indoors and on public transportation, ventilating crowded and public spaces (such as schools, offices, and public transport), and applying rigorous therapeutic protocols for those at risk of severe disease.

In Kazakhstan, over the past two weeks, the number of cases increased by 3.2 times, said Kazakh Minister of Healthcare Azhar Giniyat at a government meeting on August 2.

But the number of infections has been going down for the past several days. Over the past 24 hours, Kazakhstan reported 1,373 new COVID-19 cases, including 301 new in Nur-Sultan, 202 in Almaty, 12 in Shymkent, and 89 in the Akmola region. The day before, the number of new infections was 1,988.

«According to official statistics, 1.4 million people have been diagnosed with coronavirus infection since the beginning of the pandemic. We have experienced five waves of infection. Since June 20, another rise in the incidence of coronavirus has been registered in the country. Over the past two weeks, the number of people falling ill has increased by 3.2 times,» said Giniyat.

According to her, the surge in cases is caused by a subvariant of the Omicron BA.5, which, according to the results of a genetic study conducted in the country in July, is observed in 70 percent of the examined samples.

«This variant is characterized by high contagiousness and the symptoms are milder than the Delta variant. This is confirmed by the fact that more than 94 percent of people contracting COVID-19 are treated as outpatients,« said the minister.

Three types of vaccines are currently available in Kazakhstan – Kazakhstan’s own QazVac, Sinopharm and Pfizer. The minister said an additional 500,000 doses of QazVac vaccine and 300,000 doses of the Pfizer vaccine will be purchased by the end of the year.

Giniyat urged the citizens to vaccinate and revaccinate. She noted vaccination and booster shots remain the only protection against infection, as up to 80 percent of COVID-19 infections are among people who are unvaccinated or were vaccinated 6 months ago.

Written by Assel Satubaldina


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