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https://www.readbyqxmd.com/read/27852504/bilateral-rib-based-distraction-to-the-pelvis-for-the-management-of-congenital-gibbus-deformity-in-the-growing-child-with-myelodysplasia
#1
John T Smith
BACKGROUND: Congenital gibbus deformity of the spine associated with myelodysplasia is a challenging problem in the growing child and is commonly associated with skin breakdown and chronic infection. Surgical solutions including kyphectomy, flap closure of the skin, and early spinal fusion are associated with a high rate of complications and, ultimately, a short trunk due to stoppage of spinal growth. The purpose of this article is to describe our early results in using a rib-based distraction to the pelvis without vertebral resection and fusion to manage this deformity...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27852502/variability-of-surgical-site-infection-with-veptr-at-eight-centers-a%C3%A2-retrospective-cohort-analysis
#2
Sumeet Garg, Micaela Cyr, Tricia St Hilaire, Tara Flynn, Patrick Carry, Michael Glotzbecker, John T Smith, Jeffrey Sawyer, Joshua Pahys, Scott Luhmann, John M Flynn, Ron El-Hawary, Michael Vitale
STUDY DESIGN: Retrospective review. OBJECTIVES: To describe clinical characteristics and infection rates in modern vertical expandable prosthetic titanium rib (VEPTR) surgery. SUMMARY OF BACKGROUND DATA: Prior studies have demonstrated infection rates from 10% to 30% with VEPTR surgery. METHODS: A retrospective query was done on an institutional review board-approved, multicenter prospectively collected database for patients implanted with VEPTR from 2007 to 2013 at eight sites...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27397045/complications-in-using-the-vertical-expandable-prosthetic-titanium-rib-veptr-in-children
#3
John H T Waldhausen, Greg Redding, Klane White, Kit Song
PURPOSE: This report describes complications using the vertical expandable prosthetic titanium rib (VEPTR) for thoracic insufficiency syndrome (TIS) at a single center. METHODS: This is a prospective cohort evaluating 65 patients with rib-rib and rib-spine VEPTR devices for TIS placed between 10/2001 and 11/2014, for children with spinal or chest wall deformity. Patients were classified using the early onset scoliosis classification system (C-EOS). RESULTS: 65 patients are available for follow up...
June 26, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27196004/treatment-of-early-onset-spinal-deformity-eosd-with-veptr-a-challenge-for-the-final-correction-spondylodesis-a-case-series
#4
Friederike Lattig, Rita Taurman, Anna K Hell
STUDY DESIGN: Case Series. OBJECTIVE: To describe the post-VEPTR (vertical expandable prosthetic titanium rib) treatment changes in early-onset spinal deformity (EOSD), which may influence the final correction spondylodesis. SUMMARY OF BACKGROUND DATA: The VEPTR device, originally developed for the treatment of congenital rib cage malformation, is nowadays more widely used in the treatment of EOSD. At present, only a few reports describe the possible complications that may occur with repeated lengthening procedures of the VEPTR, thereby making the final spondylodesis more complicated and less satisfactory...
June 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/26957100/validity-and-utility-of-monopolar-spinal-cord-stimulation-in-pediatric-scoliosis-surgery
#5
Constantin Gomes, Mathieu Kuchenbuch, Grégory Lucas, Soizic Argaud, Philippe Violas, Paul Sauleau
PURPOSE: To assess the validity and utility of monopolar stimulation (between a peridural needle and a large adhesive anode placed in the sternal area) for intraoperative monitoring in scoliosis surgery. METHODS: This procedure was assessed during 41 operations involving either arthrodesis with posterior instrumentation or a Vertical Expandable Prosthetic Titanium Rib (VEPTR). Responses evoked by monopolar stimulation were compared with those evoked by bipolar stimulation between two epidural needle electrodes...
March 8, 2016: European Spine Journal
https://www.readbyqxmd.com/read/26769614/congenital-scoliosis-mini-review
#6
REVIEW
Hans-Rudolf Weiss, Marc Moramarco
Congenital scoliosis is a lateral deformity of the spine with a disturbance of the sagittal profile caused by malformations of vertebra and ribs. Typically, early surgical intervention is the suggested treatment (before three-years-old) for young patients with congenital scoliosis. While a previous study was conducted in 2011 to investigate long-term studies supporting the necessity for this recommendation and no evidence was found, this current review, is an updated search for evidence published from 2011 through March 2015...
2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/26747620/thoracic-insufficiency-syndrome
#7
Oscar Mayer, Robert Campbell, Patrick Cahill, Gregory Redding
Thoracic insufficiency syndrome (TIS) is a broad grouping of disorders that have a substantial impact on the chest wall, spine, and in many situations, both. While the conditions are varied, they share a potentially substantial impact on respiratory capacity and development over time and a presentation and need for intervention that is often in early childhood. Addressing these conditions has required a new paradigm that involves both deformity correction and a preservation of growth capacity. While there are now a number of options to treat severe spinal deformity early in life, when the deformity causes or is caused by a chest wall deformity, the Vertical Expandable Prosthetic Titanium Rib(VEPTR) is able to support surgical correction of both...
March 2016: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/26692699/the-effect-of-vertical-expandable-prosthetic-titanium-rib-on-growth-in-congenital-scoliosis
#8
Mehmet Bulent Balioglu, Akif Albayrak, Yunus Emre Akman, Yunus Atici, Deniz Kargin, Mehmet Akif Kaygusuz
AIMS: In the treatment of thoracic insufficiency syndrome, the main aim is to maintain spinal and thoracic growth in order to continue respiratory functions. Vertical expandable prosthetic titanium rib (VEPTR) device application is a method of choice especially in the congenital cases with a thoracic deformity. In our study, we evaluated the effect of VEPTR on growth in congenital scoliosis. MATERIALS AND METHODS: Four female patients in whom VEPTR was applied were retrospectively evaluated...
October 2015: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/26692697/a-comparison-of-the-effects-of-two-different-techniques-on-shoulder-balance-in-the-treatment-of-congenital-scoliosis-vertical-expandable-prosthetic-titanium-rib-and-dual-growing-rod
#9
Yunus Atici, Yunus Emre Akman, Mehmet Bulent Balioglu, Sinan Erdogan
PURPOSE: The purpose of this study is to compare the effects of two different growth guidance techniques (dual growing rod and vertical expandable prosthetic titanium rib [VEPTR]) on shoulder balance, in the surgical treatment of congenital scoliosis. MATERIALS AND METHODS: Thirteen patients who were operated due to congenital scoliosis are divided into two groups. The coracoid height difference and clavicular tilt angle difference were measured on standing anteroposterior X-ray images in the preoperative, early postoperative periods, and during the last follow-up...
October 2015: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/26573161/congenital-scoliosis
#10
M Moramarco, H R Weiss
Congenital scoliosis is a lateral deformity of the spine with a disturbance of the sagittal profile caused by malformations of vertebra and ribs. Typically, early surgical intervention is the suggested treatment (before three-years-old) for young patients with congenital scoliosis. While a previous study was conducted in 2011 to investigate long-term studies supporting the necessity for this recommendation and no evidence was found , this current review, is an updated search for evidence published from 2011 through March 2015...
November 17, 2015: Current Pediatric Reviews
https://www.readbyqxmd.com/read/26566066/the-classification-for-early-onset-scoliosis-c-eos-correlates-with-the-speed-of-vertical-expandable-prosthetic-titanium-rib-veptr-proximal-anchor-failure
#11
Howard Y Park, Hiroko Matsumoto, Nicholas Feinberg, David P Roye, Wajdi W Kanj, Randal R Betz, Patrick J Cahill, Michael P Glotzbecker, Scott J Luhmann, Sumeet Garg, Jeffrey R Sawyer, John T Smith, John M Flynn, Michael G Vitale
BACKGROUND: The Classification for Early-onset Scoliosis (C-EOS) was developed by a consortium of early-onset scoliosis (EOS) surgeons. This study aims to examine if the C-EOS classification correlates with the speed (failure/unit time) of proximal anchor failure in EOS surgery patients. METHODS: A total of 106 EOS patients were retrospectively queried from an EOS database. All patients were treated with vertical expandable prosthetic titanium rib and experienced proximal anchor failure...
November 13, 2015: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/26386889/fusionless-surgery-in-early-onset-scoliosis
#12
REVIEW
T Odent, B Ilharreborde, L Miladi, N Khouri, P Violas, J Ouellet, V Cunin, J Kieffer, K Kharrat, F Accadbled
BACKGROUND: Surgical treatment of early-onset scoliosis has greatly developed in recent years. Early-onset scoliosis covers a variety of etiologies (idiopathic, neurologic, dystrophic, malformative, etc.) with onset before the age of 5 years. Progression and severity threaten respiratory development and may result in respiratory failure in adulthood. Many surgical techniques have been developed in recent years, aiming to protect spinal and thoracic development. MATERIAL AND METHODS: Present techniques are based on one of two main principles...
October 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/26356068/parasol-rib-deformity-in-hypotonic-neuromuscular-scoliosis-a-new-radiographical-definition-and-a-comparison-of-short-term-treatment-outcomes-with-veptr-and-growing-rods
#13
MULTICENTER STUDY
Kristin Livingston, David Zurakowski, Brian Snyder
STUDY DESIGN: Retrospective review of 2 multicenter national databases, Growing Spine Study Group and Chest Wall and Spine Deformity. OBJECTIVE: To derive an objective measure of parasol rib deformity from spine radiographs and to compare efficacy of rib-based (vertical expandable prosthetic titanium rib (VEPTR)) versus spine-based growing rods ("GR") instrumentation to improve parasol rib deformity and pulmonary function. SUMMARY OF BACKGROUND DATA: Children with low tone neuromuscular scoliosis often develop collapse of the rib cage ("parasol rib deformity") that may be associated with poor pulmonary function...
July 1, 2015: Spine
https://www.readbyqxmd.com/read/26260096/metamorphosis-of-human-lumbar-vertebrae-induced-by-veptr-growth-modulation-and-stress-shielding
#14
Carol C Hasler, Daniel Studer, Philippe Büchler
INTRODUCTION: Distraction-based spinal growth modulation by growing rods or vertical expandable prosthetic titanium ribs (VEPTRs) is the mainstay of instrumented operative strategies to correct early onset spinal deformities. In order to objectify the benefits, it has become common sense to measure the gain in spine height by assessing T1-S1 distance on anteroposterior (AP) radiographs. However, by ignoring growth changes on vertebral levels and by limiting measurement to one plane, valuable data is missed regarding the three-dimensional (3D) effects of growth modulation...
August 2015: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/25976015/bacterial-colonization-of-veptr-implants-under-repeated-expansions-in-children-with-severe-early-onset-spinal-deformities
#15
Christian Plaass, Carol Claudius Hasler, Ulrich Heininger, Daniel Studer
PURPOSE: Historically, severe spinal and thoracic deformities in children were treated with early long spinal fusions. This prevented further growth of the spine and thorax and often led to small stiff thoraces. Therefore, growth-retaining implants, like vertical expandable titanium ribs (VEPTR), were developed to stimulate thoracic and spinal growth. To accommodate growth, these implants have to be expanded every 6 months. Infection rates of up to 2 % per procedure are reported. Exchange of implant parts allows analyzing the development of implant-related infections and subclinical colonizations...
February 2016: European Spine Journal
https://www.readbyqxmd.com/read/25944296/the-effect-of-growing-rod-treatment-on-hemoglobin-and-hematocrit-levels-in-early-onset-scoliosis
#16
Kody K Barrett, Christopher Lee, Karen Myung, Charles Johnston, Suken A Shah, Behrooz A Akbarnia, David L Skaggs
BACKGROUND: This study examines preoperative hemoglobin (Hgb) and hematocrit (Hct) levels in a group of early-onset scoliosis (EOS) patients and the effect of distraction-based growing rods (GRs) on these levels. Children with EOS are at risk for respiratory insufficiency and chronic hypoxemia. Increased Hgb and Hct levels have been identified as surrogate markers for chronic hypoxemia. A study of patients who underwent VEPTR surgery showed a significant decrease in Hgb levels following surgery...
September 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/25887832/use-of-vertical-expandable-prosthetic-titanium-rib-veptr-in-the-treatment-of-congenital-scoliosis-without-fused-ribs
#17
Robert F Murphy, Alice Moisan, Derek M Kelly, William C Warner, Tamekia L Jones, Jeffrey R Sawyer
BACKGROUND: Although the vertical expandable prosthetic titanium rib (VEPTR) has been shown to be useful in treating congenital scoliosis (CS) with fused ribs, no studies to date have specifically evaluated the efficacy of VEPTR in the treatment of CS without fused ribs. The purpose of this study was to determine the effectiveness of VEPTR in sagittal/coronal curve correction and spine growth and compare its complication rate to the use of VEPTR in other conditions and to other treatment methods used for CS...
June 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/25822545/parasol-rib-deformity-in-hypotonic-neuromuscular-scoliosis-a-new-radiographic-definition-and-a-comparison-of-short-term-treatment-outcomes-with-veptr-and-growing-rods
#18
Kristin Livingston, David Zurakowski, Brian Snyder
STUDY DESIGN: Retrospective review of two multicenter national databases, Growing Spine Study Group and Chest Wall and Spine Deformity. OBJECTIVE: To derive an objective measure of parasol rib deformity from spine radiographs and to compare efficacy of rib-based (VEPTR) vs. spine-based growing rods ("GR") instrumentation to improve parasol rib deformity and pulmonary function. SUMMARY OF BACKGROUND DATA: Children with low tone neuromuscular scoliosis often develop collapse of the rib cage ("parasol rib deformity") that may be associated with poor pulmonary function...
March 27, 2015: Spine
https://www.readbyqxmd.com/read/25730379/veptr-implantation-after-age-3-is-associated-with-similar-radiographic-outcomes-with-fewer-complications
#19
MULTICENTER STUDY
Vidyadhar V Upasani, Patricia E Miller, John B Emans, John T Smith, Randal R Betz, John M Flynn, Michael P Glotzbecker
BACKGROUND: 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...
April 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/25705803/vitamin-d-deficiency-in-children-undergoing-vertical-expandable-prosthetic-titanium-rib-treatment
#20
Ying Li, Nahbee Jong, Michelle S Caird, Allison Tenfelde, Philip Nowicki, Kerby Shedden, Virginia S Nelson, Frances A Farley
BACKGROUND: Vitamin D deficiency is prevalent in the pediatric population and multiple risk factors have been identified. Low vitamin D levels can result in poor bone mineralization and have been associated with a significantly higher risk of forearm fracture in children. Vitamin D deficiency has also been associated with pediatric critical illness. The purpose of this study was to determine whether children undergoing vertical expandable prosthetic titanium rib (VEPTR) treatment have low vitamin D levels...
December 2015: Journal of Pediatric Orthopedics
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