VEPTR Expansion Thoracoplasty for Thoracic Insufficiency
Vertical Expandable Prosthetic Titanium Rib (VEPTR) expansion thoracoplasty was recently approved by the Food and Drug Administration for treatment of thoracic insufficiency syndrome in skeletally immature patients. Thoracic insufficiency syndrome (TIS) is usually associated with uncommon three-dimensional deformities of both the spine and rib cage. Several types of VEPTR based expansion thoracoplasties operations can be used for different types of deformities to gain chest volume for growth of the underlying lungs while indirectly correcting the scoliosis without spine fusion. VEPTR surgery is extensive, devices are placed under the scapula (shoulder blade) and are attached to the ribs near the neck and continue down to either the spine, or the ribs near the waist, this helps to stabilize the surgically expanded chest wall constriction (expansion thoracoplasty). To accommodate later growth, the devices are expanded twice a year in outpatient surgery through small incisions. Currently, there are a limited number of institutions offering VEPTR surgery. Your child's spine surgeon can advise whether your child's condition is appropriate for VEPTR treatment and provide referral information, if needed. Some centers are using the VEPTR device as a means to straighten the spine indirectly via the ribs and chest wall.