This report is being filed after the subsequent review of the following journal article.Proximal junctional kyphosis after vertical expandable prosthetic titanium rib insertion.Ying li, md, meryl gold, ba, lawrence karlin, md.Spine deformity 1 (2013) 425-433.The literature article is attached to the complaint.This is a retrospective review of patients who had undergone vertical expandable prosthetic titanium rib (veptr) treatment at a single institution.A total of 68 patients underwent veptr treatment between 1999 and 2009.Diagnosis, age at time of veptr insertion, location of veptr anchors, preoperative and postoperative scoliosis, t2-t12 kyphosis and proximal junctional kyphosis (pjk), time from veptr insertion to development of pjk, revision procedure for significant pjk, change in pjk after the revision procedure, and pjk at final follow-up were recorded.Four patients developed pjk (6 percent).One patient had congenital scoliosis with rib fusions, 1 had scoliosis associated with a syndrome (arthrogryposis), and 2 had neuromuscular scoliosis (core myopathy and spinal cord tumor).Mean follow-up was 5.7 years.All patients developed pjk within the first year after veptr insertion.Two patients underwent revision to growing rods.One of these patients had preoperative halo-gravity traction.Mean pjk in these 2 patients improved after revision and remained stable at an average follow-up of 2.9 years.This report is for unknown veptr construct.This is report 1 of 5 for complaint (b)(4).For 64 unknown patients who developed pjk.
|