The Classification for Early-onset Scoliosis (C-EOS) Correlates With the Speed of Vertical Expandable Prosthetic Titanium Rib (VEPTR) Proximal Anchor Failure.
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 t...
| Publicado en: | Journal of Pediatric Orthopaedics Vol. 37; no. 6; pp. 381 - 387 |
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| Autores principales: | , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Sep2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124731064&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124731064 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02716798 4CC jtl: Journal of Pediatric Orthopaedics issn: 02716798 maglogo: N pubinfo: dt: Sep2017 vid: 37 iid: 6 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 124731064 124731064 NLM26566066 124731064 10.1097/BPO.0000000000000682 NLM26566066 124731064 ppf: 381 ppct: 6 formats: tig: atl: The Classification for Early-onset Scoliosis (C-EOS) Correlates With the Speed of Vertical Expandable Prosthetic Titanium Rib (VEPTR) Proximal Anchor Failure. aug: au: Park, Howard Y. Hiroko Matsumoto Feinberg, Nicholas Roye, David P. Kanj, Wajdi W. Betz, Randal R. Cahill, Patrick J. Glotzbecker, Michael P. Luhmann, Scott J. Garg, Sumeet Sawyer, Jeffrey R. Smith, John T. Flynn, John M. Vitale, Michael G. Matsumoto, Hiroko affil: Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA sug: subj: Sutures Prostheses and Implants Scoliosis Classification Ribs Surgery Retrospective Design Adolescence Female Male Child Age of Onset Titanium Scoliosis Surgery Treatment Failure Time Factors Human Scoliosis Etiology Child, Preschool Validation Studies Comparative Studies Evaluation Research Multicenter Studies Funding Source Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Female Male ab: 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. Patients were classified by the C-EOS, which includes a term for etiology [C: Congenital (54.2%), M: Neuromuscular (32.3%), S: Syndromic (8.3%), I: Idiopathic (5.2%)], major curve angle [1: ≤20 degrees (0%), 2: 21 to 50 degrees (15.6%), 3: 51 to 90 degrees (66.7%), 4: >90 degrees (17.7%)], and kyphosis ["-": ≤20 (13.5%), "N": 21 to 50 (42.7%), "+": >50 (43.8%)]. Outcome was measured by time and number of lengthenings to failure.Results: Analyzing C-EOS classes with >3 subjects, survival analysis demonstrates that the C-EOS discriminates low, medium, and high speed of failure. The low speed of failure group consisted of congenital/51-90/hypokyphosis (C3-) class. The medium-speed group consisted of congenital/51-90/normal and hyperkyphosis (C3N, C3+), and neuromuscular/51-90/hyperkyphosis (M3+) classes. The high-speed group consisted of neuromuscular/51-90/normal kyphosis (M3N), and neuromuscular/>90/normal and hyperkyphosis (M4N, M4+) classes. Significant differences were found in time (P<0.05) and number of expansions (P<0.05) before failure between congenital and neuromuscular classes.As isolated variables, neuromuscular etiology experienced a significantly faster time to failure compared with patients with idiopathic (P<0.001) and congenital (P=0.026) etiology. Patients with a major curve angle >90 degrees demonstrated significantly faster speed of failure compared with patients with major curve angle 21 to 50 degrees (P=0.011).Conclusions: The ability of the C-EOS to discriminate the speeds of failure of the various classification subgroups supports its validity and demonstrates its potential use in guiding decision making. Further experience with the C-EOS may allow more tailored treatment, and perhaps better outcomes of patients with EOS.Level Of Evidence: Level III. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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