Holtz Children’s Hospital’s First-Ever Spinal Tethering Case

By: Miranda Torres

Edel Perez, 13, was a normal teenage boy until his pediatrician noticed something off during a wellness visit in April 2024. There was a large bump on the right side of his spine. Edel was diagnosed with scoliosis, and sent to a local hospital to be fitted for a brace, which he would need to always wear.

Ultimately, the brace didn’t help, so his parents sought out a second opinion with Brian Grottkau, MD, chief of pediatric orthopedics and pediatric surgical services at Holtz Children’s Hospital, and Shriners Children’s endowed chair in pediatric orthopedics at University of Miami Miller School of Medicine.

“Dr. Grottkau was incredible since the first time we met him,” said Maria Canizo, Edel’s mother. “He doesn’t influence you to make any decision, but explains to you the different treatment options and makes you feel comfortable enough to make your own decision.”

Dr. Grottkau determined that Edel had a 51-degree thoracic curvature (chest) and 30-degree lumbar curvature (lower spinal column), making him an ideal candidate for anterior vertebral body tethering, an operation that corrects the curvature while still allowing the spine to be flexible and grow.

This would be the first procedure of its kind at Holtz Children’s, revolutionizing the way scoliosis patients receive care.

“I knew it wasn’t only about the surgery itself, but finding the right doctor who makes you feel comfortable,” Canizo said. “With the faith that I had in Dr. Grottkau and all the research I did about the benefits of this procedure, which he co-developed, we knew Edel was in the right hands.”

On September 17, 2024, Dr. Grottkau performed the 11-hour surgery.

Some of the benefits to an anterior vertebral body tethering include less blood loss, less recovery time in the hospital, minimal mobility loss, and lower neurological risks.

“Anywhere in orthopedics where we have attempted to preserve mobility, the quality of life has also increased, and I believe the same is true for scoliosis,” Dr. Grottkau said. “Once doctors become more experienced in spinal tethering, it’ll become the standard method of scoliosis treatment.”

About four weeks after surgery, Edel was able to go back to school. He was be able to return to all regular activities by December 2024.

“We’re the only ones in South Florida that currently offer the full spectrum of treatment for scoliosis, from observation and bracing to tethering and fusion,” Dr. Grottkau said. “We’re the only ones able to match the treatment intervention to their particular case.”

“Like any other parent that hears their child needs surgery, I was terrified,” Canizo added “I still can’t believe that after being so worried, you can’t even tell he went through spinal surgery. I could never express my gratitude enough to Dr. Grottkau for the ways he has impacted our lives.”