Spine deformity · 2026
VEPTR treatment of early onset scoliosis in children without rib abnormalities: 10-year follow-up from a prospective multicenter study.
СтатьяНазвание и аннотация: Перевод в очереди
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Alberghina Flavia, El-Hawary Ron, Morash Kevin, Vitale Michael, Smith John, Samdani Amer, Pediatric Spine Study Group, Flynn John
Аннотация
PURPOSE: In 2007, a prospective study on VEPTR treatment of EOS in children without rib abnormalities was initiated. Two-year and 5-year follow-up results from this cohort have previously demonstrated that scoliosis is controlled, and spinal growth continues. This study examines whether, at long-term follow-up, VEPTR continues to control scoliosis and allow spinal growth.
METHODS: Prospective, multicenter cohort of participants with EOS without rib abnormalities who underwent VEPTR. Pre-implantation and last available images were compared, regardless of whether VEPTR remained in vivo.
RESULTS: 33 patients were available for evaluation (mean age at insertion 4.8 ± 2.5 yrs; mean f/u 10.6 ± 2.7 yrs; mean 14.6 surgeries. Currently 14 patients still have VEPTR, 17 have converted and 2 have had VEPTR explanted. On last available imaging (mean f/u 10.4 ± 1.7 yrs), scoliosis improved from 72 ± 16° preop to 61 ± 22° (p < 0.001) and T1-T12 coronal height increased (14.5 ± 2.3 to 19.6 ± 3.9 cm, p < 0.001). Maximum kyphosis increased from 41 ± 19 to 62 ± 26° (p < 0.001). T1-T12 sagittal length (cm) increased from 15.6 ± 2.3 to 20.2 ± 3.9° (p < 0.001). A subset of 14 patients who still have VEPTR in vivo was analyzed: mean age at insertion was 4.6 ± 2.8 yrs, with a mean VEPTR treatment duration of 10.7 ± 3 yrs. Scoliosis improved from preop (79 ± 16 to 66 ± 23°, p = 0.01). T1-T12 coronal height increased (13.9 ± 2.1 to 18.5 ± 3.3 cm, p = 0.001). Maximum kyphosis increased from 40 ± 28 to 66 ± 23° (p = 0.011). T1-T12 sagittal length (cm) increased from 15.2 ± 2.6 to 18.9 ± 3° (p < 0.001). Thirty-one patients (93%) experienced at least 1 complication, with 93 total complications observed. Eighteen patients (54%) required at least one unplanned surgery.
CONCLUSION: With long-term follow up, VEPTR continues to control scoliosis and allow spinal growth. However, kyphosis increased, and most patients experienced at least one complication.
LEVEL OF EVIDENCE: Level II-prospective cohort, therapeutic study.
METHODS: Prospective, multicenter cohort of participants with EOS without rib abnormalities who underwent VEPTR. Pre-implantation and last available images were compared, regardless of whether VEPTR remained in vivo.
RESULTS: 33 patients were available for evaluation (mean age at insertion 4.8 ± 2.5 yrs; mean f/u 10.6 ± 2.7 yrs; mean 14.6 surgeries. Currently 14 patients still have VEPTR, 17 have converted and 2 have had VEPTR explanted. On last available imaging (mean f/u 10.4 ± 1.7 yrs), scoliosis improved from 72 ± 16° preop to 61 ± 22° (p < 0.001) and T1-T12 coronal height increased (14.5 ± 2.3 to 19.6 ± 3.9 cm, p < 0.001). Maximum kyphosis increased from 41 ± 19 to 62 ± 26° (p < 0.001). T1-T12 sagittal length (cm) increased from 15.6 ± 2.3 to 20.2 ± 3.9° (p < 0.001). A subset of 14 patients who still have VEPTR in vivo was analyzed: mean age at insertion was 4.6 ± 2.8 yrs, with a mean VEPTR treatment duration of 10.7 ± 3 yrs. Scoliosis improved from preop (79 ± 16 to 66 ± 23°, p = 0.01). T1-T12 coronal height increased (13.9 ± 2.1 to 18.5 ± 3.3 cm, p = 0.001). Maximum kyphosis increased from 40 ± 28 to 66 ± 23° (p = 0.011). T1-T12 sagittal length (cm) increased from 15.2 ± 2.6 to 18.9 ± 3° (p < 0.001). Thirty-one patients (93%) experienced at least 1 complication, with 93 total complications observed. Eighteen patients (54%) required at least one unplanned surgery.
CONCLUSION: With long-term follow up, VEPTR continues to control scoliosis and allow spinal growth. However, kyphosis increased, and most patients experienced at least one complication.
LEVEL OF EVIDENCE: Level II-prospective cohort, therapeutic study.