REMINDER: ORLive Presents: Avoiding Fusion in Early-Onset Scoliosis: Growing Rods and the VEPTR (Vertical Expanding Prosthetic Titanium Ribs): Treatment Option for Children Suffering From Early-Onset Scoliosis
Live Webcast: From Morgan Stanley Children's Hospital of NewYork-Presbyterian: December 5, 2007 7:00 PM EST (00:00 UTC)
NEW YORK, NY -- (MARKET WIRE) -- 12/05/07 -- On Wednesday December 5th, join experts from
Morgan Stanley Children's Hospital of NewYork-Presbyterian for a live panel
discussion on VEPTR and growing rods to treat early-onset
scoliosis on www.OR-Live.com.
Patients with early-onset scoliosis can develop severe, complex spinal
deformity that distorts and reduces the volume of the thorax. This
deformity inhibits the growth of alveoli and pulmonary arterioles during
the critical lung maturation period between birth and the age of eight. The
resulting condition, thoracic insufficiency syndrome
(TIS), can be a life-threatening condition that compromises respiratory
function and increases morbidity. It can also cause a significant increase
in mortality rates in affected individuals.
Growing rods attach to the spine and are affixed to vertebrae at the top
and the bottom. Rods can be placed on either one or both sides of the
spine, and are "grown" over time using a special mechanism that allows the
lengthening to be performed in a simple outpatient surgery. VEPTR is used
to treat absent or fused ribs, and consists of a titanium brace placed
between two ribs to push them apart, which straightens the spine and opens
a larger space for the lungs and other internal organs to grow. Like
growing rods, VEPTR can be expanded as the patient grows.
Treating early-onset scoliosis with growing rods and/or VEPTR permits
continued growth of the spine, maximizes space available for lungs, and
enhances pulmonary function. By increasing pulmonary capacity as well as
straightening the spine, these treatments provide significant
quality-of-life improvements in the child's ability to breathe, to talk, to
eat, and to live. Spinal fusion, by contrast,
irreversibly limits growth of the patient's spine, thorax, and lungs. The
resulting respiratory insufficiency has a progressive negative impact,
starting with low vitality (the child tires easily and has trouble talking
and eating). If the respiratory status deteriorates further, respiratory
support may be required, and the risk of recurrent pneumonia increases
along with mortality.
VEPTR and growing rod procedures are generally shorter surgeries with less
blood loss and fluid shifts than traditional spinal surgery. However,
treatment for children with a severe spinal and thoracic deformity is a long-term
commitment. Lengthening of the growing rods and expansion of the VEPTR to
accommodate growth of the spine and organs is needed at four-to-six month
intervals. Although the expansions are relatively minor surgical
procedures, these surgeries continue over a period of years until maximum
spinal growth is achieved. Given the duration of treatment, additional
unplanned surgeries are likely although complication rates are considered
acceptable.
The complex care required by children diagnosed with early-onset scoliosis has
tended to limit their treatment to children's hospitals offering a
convergence of strong orthopedic, pulmonary, and ICU facilities. Morgan
Stanley Children's Hospital of NewYork-Presbyterian is one of a group of
several hospitals working to advance growing rod and VEPTR treatments. Our
orthopedic teams have significant experience in applying these techniques,
and are continuing to develop and test techniques, and share in research,
with the expectation of even better outcomes in the future.
Visit:
http://www.or-
live.com/NYP/1778 to learn more about scoliosis treatment and view a
program preview. VNR: http://www.or-live.com/rams/nep-1778-mkw-q.ram
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