VEPTR

The acronym VEPTR stands for vertical expandable titanium prosthetic rib ( English Vertical Expandable Prosthetic Titanium ribs ), a product of Synthes for treating infantile deformities of the thorax . It is a special form of an extendable rod (" Growing Rod "). An alternative system is the USS pediatric instrument set for older children, also from Synthes.

The instruments are used to expand and straighten a rib thorax that is too small or too narrow in the event of a severe thoracic deformity . It consists of an extendable "titanium rib" in a curved shape with several holes in a row for fixing in the desired length. An extension can be made surgically every 6 months. The fixation takes place between two ribs or between one rib and the iliac crest. This results in an indirect straightening of the deformed spine and thus an increase in volume of the rib thorax including the lungs.

Thoracic scoliosis due to MMC with diastematomyelia, 10 year old boy

Same patient after VEPTR implantation

Indications

Indications are:

thoracic insufficiency syndrome (respiratory insufficiency caused by bony deformity and narrowing of the lungs)
congenital scoliosis with or without rib synostosis
"Early onset" scoliosis (EOS)
neurogenic scoliosis

Contraindications

Contraindications are:

severe kyphosis > 70 ° ( Cobb angle )
osteoporotic spinal changes
Children> 10 years for the VEPTR system

history

The first patient application of a titanium rib was in 1989 in San Antonio, USA.

This procedure was first carried out in Europe in 2002 in Basel .

literature

K. Ridderbusch, M. Rupprecht, P. Kunkel, R. Stücker: Nonfusion techniques for the treatment of childhood scoliosis. In: The orthopedist. Vol. 42, No. 12, December 2013, ISSN 1433-0431 , pp. 1030-1037, doi: 10.1007 / s00132-012-2049-x , PMID 23982693 .

T. Pfandlsteiner, P. Wallnoefer, C. Wimmer: Growth- directing surgical treatment of juvenile scoliosis with USS pediatric. In: Operative Orthopedics and Traumatology. Vol. 22, No. 2, May 2010, ISSN 1439-0981 , pp. 149-163, doi: 10.1007 / s00064-010-9013-x , PMID 20711826 .

RM Campbell: VEPTR: past experience and the future of VEPTR principles. In: European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. Vol. 22 Suppl 2, March 2013, ISSN 1432-0932 , pp. S106-S117, doi: 10.1007 / s00586-013-2671-2 , PMID 23354777 , PMC 3616470 (free full text). (Review).

Web links

VEPTR - Vertically Expandable Titanium Rib Prosthesis. A new treatment concept for pediatric, three-dimensional chest deformities. Synthes, 2006.
VEPTR - The Titanium Rib Project (patient information page)

Individual evidence

↑ C. Wimmer, P. Wallnoefer, T. Pfandlsteiner: The operative treatment of scolioses with the "vertical expandable prosthetic titanium rib" (VEPTR). In: Operative Orthopedics and Traumatology. Vol. 22, No. 2, May 2010, ISSN 1439-0981 , pp. 123-136, doi: 10.1007 / s00064-010-9038-1 , PMID 20711824 .
↑ VEPTR.COM History
↑ RM Campbell, MD Smith, T. Mayes, R. Pinero: The treatment of thoracic insufficiency syndrome scientific exhibit . In: American academy of orthopedic surgeons annual meeting 1992
^ AK Hell, RM Campbell, F. Hefti: New therapy concept for children with thoracic insufficiency syndrome due to spinal malformations. In: Clinical Pediatrics. Vol. 217, No. 5, 2005 Sep-Oct, ISSN 0300-8630 , pp. 268-273, doi: 10.1055 / s-2004-832483 , PMID 16167273 .
↑ AK Hell, F. Hefti, RM Campbell: Treatment of congenital scoliosis with the vertical-expandable-prosthetic-titanium-rib implant. In: The orthopedist. Vol. 33, No. 8, August 2004, ISSN 0085-4530 , pp. 911-918, doi: 10.1007 / s00132-004-0694-4 , PMID 15257432 .

[1] C. Wimmer, P. Wallnoefer, T. Pfandlsteiner: The operative treatment of scolioses with the "vertical expandable prosthetic titanium rib" (VEPTR). In: Operative Orthopedics and Traumatology. Vol. 22, No. 2, May 2010, ISSN 1439-0981 , pp. 123-136, doi: 10.1007 / s00064-010-9038-1 , PMID 20711824 .

[2] VEPTR.COM History

[3] RM Campbell, MD Smith, T. Mayes, R. Pinero: The treatment of thoracic insufficiency syndrome scientific exhibit . In: American academy of orthopedic surgeons annual meeting 1992

[4] AK Hell, RM Campbell, F. Hefti: New therapy concept for children with thoracic insufficiency syndrome due to spinal malformations. In: Clinical Pediatrics. Vol. 217, No. 5, 2005 Sep-Oct, ISSN 0300-8630 , pp. 268-273, doi: 10.1055 / s-2004-832483 , PMID 16167273 .

[5] AK Hell, F. Hefti, RM Campbell: Treatment of congenital scoliosis with the vertical-expandable-prosthetic-titanium-rib implant. In: The orthopedist. Vol. 33, No. 8, August 2004, ISSN 0085-4530 , pp. 911-918, doi: 10.1007 / s00132-004-0694-4 , PMID 15257432 .