Artikel
The management of severe spinal deformities with vertical expandable prosthetic titanium ribs (VEPTR): early results
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Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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Introduction
The VEPTR-procedure was introduced to Europe in 2004. We report on 5 patients who were managed with VEPTR due to congenital and thoracogenic scoliosis and present the first results from Germany so far.
Methods
There were 3 female and 2 male patients with an average age of 9,0 years (4-13 years). Of the 5 patients four suffered from congenital and one female patient from thoracogenic scoliosis. One female patient had congenital scoliosis associated with myelomeningocele.
Correction of the primary curve was measured as the difference in Cobb angle between pre- and postop X-rays. Intra- and postoperative complications were recorded. Patient- and parents satisfaction was analyzed.
Results
The primary curve measured 65° and improved to 54° after the index procedure. Intraoperative complications were not observed. 2 patients required blood transfusion. One male patient with congenital scoliosis developed a deep wound infection which required removal of one of three ribs. Another patient developed an urinary tract infection which resolved after adequate treatment.
3 of the the 5 patients had one lengthening procedure. All of them were tolerated well without sequelae and resulted in a further correction of the curves of 6°.
All patients and parents were pleased with the results and would have the procedure performed again.
Discussion
The first results after VEPTR implantations in 5 patients with severe spinal deformities are very encouraging. VEPTR is the first non fusion technique for spinal deformities which adresses both the spinal and thoracic deformities simultaneously. It avoids the need for early fusion and associated problems with the development of the so called thoracic insufficiency syndrome.