Vertical expandable prosthetic titanium rib (VEPTR) procedure

Last revised by Dr Henry Knipe on 12 Aug 2021

Vertical expandable prosthetic titanium rib (VEPTRprocedure 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. 

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