@article{19b2af5e11244450a796746aaac9471d,
title = "Spine Deformity With Fused Ribs Treated With Proximal Rib- Versus Spine-Based Growing Constructs",
abstract = "Study Design: Retrospective review of prospectively collected data. Objective: To compare the use of spine-based versus rib-based implants for the treatment of early-onset scoliosis (EOS) in the setting of rib fusions. Summary of Background Data: Treatment for severe early-onset spinal deformity with rib fusions includes growing spine devices with proximal rib or spine anchors. The results of treatment, however, have not been compared between spine-based versus rib-based proximal anchors. Methods: 169 patients with rib fusions treated with rib-based or spine-based constructs and minimum two-year follow-up were included. Sixteen patients were treated with proximal spine-based anchors and 153 with proximal rib-based devices (VEPTRs). Overall, 104 of the patients with rib-based fixation underwent thoracoplasty at the index surgery. We evaluated change in T1–T12 and T1–S1 height, coronal Cobb angle, kyphosis, and number of lengthening/revision surgeries. Results: Kyphosis increased a mean of 7° in the rib-based group and decreased a mean of 20 degrees in the spine-based group (p =.002). Major Cobb angle decreased in both groups (p <.0001); however, the spine-based group had greater Cobb angle improvement (24 vs. 11 degrees, p =.04). From implant and lengthening of distraction devices, there was a mean 3.3-cm (22%) increase in T1–T12 height and a mean of 8.0 lengthenings in the rib-based group compared with a 5.7-cm increase and 6.3 lengthening surgeries in the spine-based group. Patients with rib-based constructs had a mean of 11 total procedures, whereas spine-based patients had a mean of 8. Conclusions: Patients underwent a mean of eight lengthening surgeries before final fusion or cessation of lengthening with a modest 2.3-cm increase in T1–T12 height. Compared with proximal rib anchors, proximal spine anchors controlled kyphosis and improved Cobb angle correction for early-onset scoliosis with rib fusions.",
keywords = "Chest wall, Deformity, Early-onset scoliosis, Growing spine, Rib, Spine, Thoracic, VEPTR",
author = "{Children's Spine Study Group} and {Growing Spine Study Group} and Larson, {A. Noelle} and Baky, {Fady J.} and {St. Hilaire}, Tricia and Jeff Pawelek and Skaggs, {David L.} and Emans, {John B.} and Pahys, {Joshua M.}",
note = "Funding Information: Acknowledgments/Funding: FJB was supposed by an NIH T32 Musculoskeletal Training grant (T32AR056950). ANL was supported by an NIH grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (R03AR66342). Growing Spine Foundation financially supports the Growing Spine Study Group, which provided research data for this study. Children{\textquoteright}s Spine Foundation supports Children{\textquoteright}s Spine Study Group, which provided research data for this study. Funding Information: Author disclosures: ANL (grants from NIH T32 training grant, during the conduct of the study; other from K2M, Orthopediatrics, outside the submitted work), FJB (none), TSH (none), JP (other from San Diego Spine Foundation, outside the submitted work), DLS (grants from Pediatric Orthopaedic Society of North America & Scoliosis Research Society, paid to Columbia University; Ellipse (co–principal investigator, paid to GSF), personal fees from ZimmerBiomet; Medtronic; Zipline Medical, Inc.; Orthobullets; Grand Rounds (a health care navigation company), Green Sun Medical, other from Zipline Medical, Inc.; Green Sun Medical, from Orthobullets, nonfinancial support from Growing Spine Study Group; Scoliosis Research Society; Growing Spine Foundation , personal fees from ZimmerBiomet; Medtronic; Johnson & Johnson, other from Medtronic & ZimmerBiomet, from Wolters Kluwer Health–Lippincott Williams & Wilkins; Biomet Spine, other from Orthobullets, Co–Editor in Chief, outside the submitted work), JBE (other from Medtronics, J&J, DePuy, Synthes, and Zimmer Biomet, outside the submitted work), JMP (other from DePuy Synthes, Globus, and Zimmer, outside the submitted work), Children's Spine Study Group (grants from DePuy Synthes Spine, grants from Nuvasive, outside the submitted work), Growing Spine Study Group (grants from Growing Spine Foundation, during the conduct of the study; grants from NuVasive, outside the submitted work; the Growing Spine Foundation financially supports the Growing Spine Study Group, which provided the research data for this study. The GSF receives donations from the study group's surgeon members, medical device industry, grateful patients, and other donors). Publisher Copyright: {\textcopyright} 2018 Scoliosis Research Society",
year = "2019",
month = jan,
doi = "10.1016/j.jspd.2018.05.011",
language = "English (US)",
volume = "7",
pages = "152--157",
journal = "Spine Deformity",
issn = "2212-134X",
publisher = "Elsevier BV",
number = "1",
}