Clinical Orthopaedics and Related Research®

, Volume 469, Issue 5, pp 1335–1341

VEPTR™ Growing Rods for Early-onset Neuromuscular Scoliosis: Feasible and Effective

  • Klane K. White
  • Kit M. Song
  • Nathan Frost
  • Brian K. Daines
Symposium: Early Onset Scoliosis

Abstract

Background

The Vertical Expandable Prosthetic Titanium Rib (VEPTR™; Synthes North America, West Chester, PA) reportedly controls spinal deformity associated with constrictive chest wall conditions.

Questions/purposes

We asked whether spine-to-spine constructs using VEPTR™ instrumentation in combination with standard spinal instrumentation could be deployed to salvage failed rib-to-spine constructs used originally in patients with constricted chest walls and to primarily treat progressive spinal deformity without chest wall abnormalities.

Patients and Methods

Fifty patients were treated with VEPTR™ constructs for thoracic insufficiency syndrome at our center between 2001 and 2007. Fourteen of these 50 patients had placement of a spine-to-spine construct using a VEPTR™ implant in combination with standard spinal implants and are the subject of this retrospective review. Five had prior rib-based VEPTR™ or growing implants with an average of two failures before this surgery. Radiographic variables, preceding treatment, complications, and changes in ambulatory status, were recorded. The minimum followup was 2 years (mean, 35 months; range, 2–4 years).

Results

After an average of five expansions in these 14 patients, positive changes were recorded for Cobb angle, T1–S1 height, sagittal balance, and space available for the lung. Complications included two rod fractures, two superficial infections, and one deep infection with rod removal.

Conclusions

VEPTR™ instrumentation as a spine-to-spine growing-rod construct demonstrated ease of implantation and expansion, with complication rates similar to other reported devices. This study suggests growing constructs using VEPTR™ can be used with relatively few complications and extends the potential uses of this instrumentation system.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • Klane K. White
    • 1
    • 2
  • Kit M. Song
    • 1
    • 2
  • Nathan Frost
    • 3
  • Brian K. Daines
    • 2
  1. 1.Department of Orthopedic SurgerySeattle Children’s HospitalSeattleUSA
  2. 2.Department of Orthopaedics and Sports MedicineUniversity of WashingtonSeattleUSA
  3. 3.Department of Orthopaedic SurgeryMadigan Army Medical CenterTacomaUSA

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