The degree of vertebral issues in VACTERL is variable, and some patients will be under the care of orthopaedic surgeons, but many will be under the care of the GP for these issues. Older VACTERL patients may not have been thoroughly screened in childhood for such anomalies due to lack of awareness of the syndrome at this time. This may need GP attention for several reasons:
Recommendation: New or worsening back pain in VACTERL patients should be treated with caution and referred for specialist investigation, even if previous vertebral anomalies have not been diagnosed. VACTERL should also be considered in adults born with OA/TOF, even when not previously identified as having VACTERL association.