Vertical expandable prosthetic titanium rib (VEPTR) procedure
Citation, DOI & article data
Vertical expandable prosthetic titanium rib (VEPTR) procedure is a surgical technique that was initially developed to treat thoracic insufficiency syndrome and then it was used in congenital scoliosis with rib abnormalities, and has since been successfully used to treat early-onset scoliosis without rib abnormalities 1,2.
A variety of implants are available: rib-to-rib; rib-to-lumbar lamina, rib-to-ilium. The construct is attached superiorly and inferiorly with hooks with an extension bar placed. Subsequent extension procedures can be performed via a small incision exposing the extension bar closure 3.
The most common complications of VEPTR include 2:
- device migration (20-25%)
- infection (~15%)
- would dehiscence (~10%)
- implant failure (~10%)
One series 2 where VEPTR was performed for early onset scoliosis without rib abnormalities demonstrated at 5 years scoliosis control and spine growth with ~50% of the patients having VEPTR in situ and ~50% converted to other types of scoliosis surgery; a minority had the VEPTR explanted.
- 1. Campbell RM. VEPTR: past experience and the future of VEPTR principles. (2013) 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. 22 Suppl 2: S106-17. doi:10.1007/s00586-013-2671-2 - Pubmed
- 2. El-Hawary R, Morash K, Kadhim M, Vitale M, Smith J, Samdani A, Flynn J. VEPTR Treatment of Early Onset Scoliosis in Children Without Rib Abnormalities: Long-term Results of a Prospective, Multicenter Study. (2020) Journal of pediatric orthopedics. 40 (6): e406-e412. doi:10.1097/BPO.0000000000001454 - Pubmed
- 3. Synthes. VEPTR II. Vertical Expandable Prosthetic Titanium Rib II: Technique Guide. PDF