Co-Occurrence of Congenital Vertebral Anomalies and VACTERL-Associated Malformations: A Retrospective Analysis (2012-2019)

Introduction: Congenital anomalies affecting the spine are often associated with other systemic anomalies, including cardiac, gastrointestinal, renal, and limb malformations. This study evaluates the patterns of congenital vertebral anomalies co-occurring with VACTERL-associated anomalies in pediatric patients, using the Kids' Inpatient Database (KID) from 2012, 2016, and 2019.

Methods: A retrospective analysis of KID data for the years 2012, 2016, and 2019 was conducted to identify pediatric patients (aged 0-20 years) with congenital spinal anomalies. Co-occurring anomalies were categorized under VACTERL (vertebral, anal atresia, cardiac, tracheoesophageal fistula, renal, limb). Cluster analysis was performed to identify associations between common anomalies, including cardiac and renal malformations, and vertebral anomalies.

Results: A total of 14,500 pediatric patients were identified with congenital spinal anomalies over the study period. The most frequently observed co-occurring anomalies included atrial septal defect (ASD, 13.1%), patent ductus arteriosus (PDA, 11.9%), and renal dysplasia (9.8%). Cluster analysis revealed that 56.2% of patients with PDA also had ASD, while 35.9% of those with renal dysplasia had gastrointestinal anomalies like large intestinal atresia (LIA). Children with vertebral anomalies had a higher incidence of co-occurring cardiac and renal anomalies, particularly ASD and PDA.

Conclusion : Congenital vertebral anomalies in pediatric patients often co-occur with other VACTERL-associated anomalies, especially cardiac and renal malformations. These findings highlight the importance of multidisciplinary monitoring in patients with congenital spinal anomalies to manage co-existing systemic conditions effectively.