Authors: Amer F Samdani Tricia St Hilaire John B Emans John T Smith Kit Song Robert J Campbell Randal R Betz
Publish Date: 2009/05/20
Volume: 468, Issue: 3, Pages: 700-704
Abstract
The vertical expandable prosthetic titanium rib VEPTR was originally designed to treat chest and spine deformities in young children However older children with complex spinal deformities may also benefit from placement of a VEPTR when vertebral column resections are deemed too risky neurologically We report 1 the changes in Cobb angle T1 angle and head tilt and 2 the occurrence of complications in children older than 10 years of age treated with VEPTR From a database of 214 patients treated in a Food and Drug Administration Investigational Device Exemption study of VEPTR we identified 10 patients with assorted diagnoses who underwent surgery after age 10 and had a minimum of 24month followup mean 396 months range 24–75 months No patient sustained neurologic injury Patients underwent an average of five lengthenings The mean preoperative Cobb angle was 647° and improved to 484° Head shift improved an average of 38 cm Two devicerelated complications occurred both in the same patient Four patients have since undergone definitive spinal fusion For a select group of patients 10 years of age or older the VEPTR offers a reasonable alternative to potentially risky vertebral column resections for correcting deformities in selected patientsEach author certifies that his or her institution has 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
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