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

  • Symposium: Early Onset Scoliosis
  • Published:
Clinical Orthopaedics and Related Research®

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.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Seattle Children’s Hospital, 4800 Sand Point Way, W-7706, Seattle, WA, 98105, USA

    Klane K. White MD, MSc & Kit M. Song MD, MHA

  2. Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, WA, USA

    Klane K. White MD, MSc, Kit M. Song MD, MHA & Brian K. Daines MD

  3. Department of Orthopaedic Surgery, Madigan Army Medical Center, Tacoma, WA, USA

    Nathan Frost MD

Authors
  1. Klane K. White MD, MSc
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  2. Kit M. Song MD, MHA
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  3. Nathan Frost MD
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  4. Brian K. Daines MD
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Corresponding author

Correspondence to Kit M. Song MD, MHA.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Seattle Children’s Hospital.

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White, K.K., Song, K.M., Frost, N. et al. VEPTR™ Growing Rods for Early-onset Neuromuscular Scoliosis: Feasible and Effective. Clin Orthop Relat Res 469, 1335–1341 (2011). https://doi.org/10.1007/s11999-010-1749-y

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  • DOI: https://doi.org/10.1007/s11999-010-1749-y

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