VEPTR Implantation After Age 3 is Associated With Similar Radiographic Outcomes With Fewer Complications

Journal of Pediatric Orthopedics
Vidyadhar V UpasaniChildren’s Spine Study Group

Abstract

The purpose of this study was to analyze the risks and benefits of early vertical expandable prosthetic titanium rib (VEPTR) implantation (below 3 y of age) compared with delayed intervention (3 to 6 y of age). Early intervention with milder deformity may make device implantation easier and may facilitate symmetric chest and pulmonary development. However, later intervention may decrease the number of lengthenings required, and implant anchor points and bone quality may be better in older patients. A multicenter prospective database of patients treated with the VEPTR device was retrospectively reviewed. A total of 71 patients with minimum 5-year follow-up were included. Thirty-seven patients had VEPTR surgery below 3 years of age (group 1), and 34 patients had surgery between 3 and 6 years of age (group 2). Radiographs from the preoperative, immediate postoperative, and most recent follow-up visits were reviewed to determine coronal plane deformity and change in T1-T12 height over time. Complications were analyzed using a nonparametric mean cumulative function for the number of complications per subject over time. Patients in both groups had similar diagnoses, ASA scores (P=0.22), and number of lengthenings (10±4 in both groups...Continue Reading

References

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Citations

Jan 10, 2016·Current Problems in Pediatric and Adolescent Health Care·Oscar MayerGregory Redding
Jul 8, 2016·The Journal of Bone and Joint Surgery. American Volume·Amit JainUNKNOWN Growing Spine Study Group
May 26, 2017·Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association·Rhea K Hall, Mary Jane Rapport
Jul 13, 2016·Journal of Pediatric Orthopedics·Nolan M WessellWalter Truong
Feb 2, 2018·Journal of Pediatric Orthopedics·Nicole MichaelUNKNOWN Children’s Spine Study Group
Jun 4, 2019·Journal of Pediatric Orthopedics·Ying LiFrances A Farley
Aug 24, 2017·Journal of Pediatric Orthopedics·Jaime A GomezUNKNOWN Growing Spine Study Group
Nov 17, 2019·Spine Deformity·Patrick J CahillRobert M Campbell
Jan 25, 2020·Spine Deformity·Patrick J CahillRobert M Campbell

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