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Efficacy of distal pedicle screw fixation as a caudal foundation in VEPTR growing rod constructs for early onset scoliosis

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Abstract

Purpose

Surgical treatment of Early Onset Scoliosis (EOS) is challenging. Stable and robust foundations are vital. We have assessed a small cohort of patients with a rib-based proximal fixation and a pedicle screw-based distal foundation for a distraction based growing rod system.

Method

This is a single center study in a tertiary spinal deformity unit with a catchment population of over 6 million. We performed a retrospective radiographic evaluation of 15 patients with EOS treated with Vertical Expandable Titanium Prosthetic Rib (VEPTR) implant between 2007 and 2017. The review of medical records and imaging data was performed to identify growth of the spine and complications with pedicle screws.

Results

There were ten male and five female patients with an average age at index surgery of 4yrs 11 months. Mean length of follow-up was 6 yrs 9 months. Serial radiographs revealed improvements in mean Cobb angle of 12 degrees, T1–T12 height of 29 mm and T1–S1 height of 48 mm with no deterioration in distal LIV tilt angle. We report that none of these patients had any complications related to their pedicle screws including cut-out.

Conclusion

We report a technique which is efficacious and provides a mechanically robust distal fixation for VEPTR lengthening in early onset scoliosis.

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Funding

No funding was received.

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Authors and Affiliations

  1. Department of Spinal Surgery, Royal Orthopaedic Hospital, Bristol Road South, Birmingham, B31 2AP, UK

    Huan Dong, Rajpal Nandra, Dan Thurston, Edward Laugharne, Matthew Newton Ede, Adrian Gardner & Jwalant Mehta

Authors
  1. Huan Dong
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  2. Rajpal Nandra
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  3. Dan Thurston
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  4. Edward Laugharne
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  5. Matthew Newton Ede
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  6. Adrian Gardner
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  7. Jwalant Mehta
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Contributions

Conception/Design of work: RN, EL, JM. Acquisition of data: HD, RN, DT, EL. Analysis/interpretation of data: HD, RN, DT, EL, MN, AG, JM. Drafted or critically revised the work: HD, RN, DT, EL, MN, AG, JM. Approved version to be published: Approved version to be published. Agreed to be accountable for all aspects of work: HD, RN, DT, EL, MN, AG, JM.

Corresponding author

Correspondence to Huan Dong.

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Conflict of interest

Mr Jwalant Mehta has received previous research funding from Stryker/K2M, DepuySynthes, the Paediatric Spine Study Group (PSSG) and Centre for Disruptive Musculoskeletal Investigation (CDMI) for other research projects not related to this paper. The rest of the authors declare that they have no conflict of interest.

Ethical statement

This study was taken from data collected as part of an institutional audit of previously collected, anonymized data from standard care. In these circumstances there is no requirement in the UK for ethical approval or consent. The audit did have Institutional Review Board approval as per the policies and procedures of the institution.

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Dong, H., Nandra, R., Thurston, D. et al. Efficacy of distal pedicle screw fixation as a caudal foundation in VEPTR growing rod constructs for early onset scoliosis. Spine Deform 9, 1169–1174 (2021). https://doi.org/10.1007/s43390-021-00295-6

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  • DOI: https://doi.org/10.1007/s43390-021-00295-6

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