Vertical Expandable Prosthetic Titanium Rib (VEPTR) Technique
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- Category: Vol. 85, June 2017
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Vertical Expandable Prosthetic Titanium Rib (VEPTR) Technique, ISLAM ABOU-YOUSSEF, MOSTAFA EZZAT, HOSSAM SALAH and NORBERTO VENTURA
Abstract
Objective: To evaluate the technique and assess radiolog-ical outcomes in early onset scoliosis patients treated with VEPTR technique.
Design: Retrospective study.
Patients: 30 patients with early onset scoliosis with minimum follow-up 1 year and maximum follow-up 6 years.
Intervention: 25 patients were treated by VEPTR and 5 patients were treated by other rib-based distraction systems using VEPTR technique.
Main Outcome Measurement: Radiographs were evaluated to compare pre-operative and post-operative (last follow-up) changes in sagittal and coronal changes in Cobb's angels as well as the change in Space Available for Lung (SAL) ratio.
Results: 8 cases of congenital scoliosis, 3 infantile scoliosis and the others were scoliosis associated with; spinal cord tumors, osteogenesis imperfecta, Jarcho Levin syndrome, spinal muscular atrophy, arthrogryposis, and congenital my-opathy. The age at surgery varied between 2 and 10 years (6.7). The average Cobb's angle preoperatively in the antero-posterior view was 88.2º, while the post-operative average was 57.3º (percentage of correction 34%). The average (SAL%) was 77.9% pre-operatively, and has been improved to become 93.5% post-operatively (improvement 25%).
Complications: The complications rate was (40%). Com-plications varied from mortality “one case (3.3%)” to skin slough, surgical site infection, junctional kyphosis, metal failure, and pelvic hook migration.
Conclusion: VEPTR technique represents a good alterna-tive to “spine to spine growing rod techniques” in well selected cases. Complications rate is high with regard to the nature of deformity and number of “lengthening procedures”.