What is the role of the VEPTR procedure in congenital spinal deformity

The vertical expandable prosthetic titanium rib instrumentation (VEPTR) was developed to treat the thoracic insufficiency syndrome (defined as the inability of the thorax to support normal respiration and lung growth) associated with fused ribs. Following thoracoplasty of the fused ribs, the device lengthens and expands the hypoplastic hemithorax. When used in congenital scoliosis associated with fused ribs, growth of the concave and convex sides of the spine, including growth through unilateral unsegmented bars, may occur in addition to hemithorax enlargement.

Key Points

1. The prognosis for a congenital spinal deformity depends on three factors: type of anomaly, patient age, and location of the defect.

2. A wide range of intraspinal and extraspinal anomalies is associated with congenital spinal deformities, and thorough workup for associated abnormalities is critical.

3. MRI of the spine is an integral part of the evaluation of a patient with congenital spinal deformity.

4. Orthoses have little effect on progression of congenital spinal deformities.

5. Early surgical intervention is advised for progressive congenital spinal deformities to balance spinal growth and avoid development of rigid deformity and secondary structural curvatures.


Classification of congenital scoliosis and kyphosis: http://www.medscape.com/viewarticle/707687 Congenital scoliosis: http://www.srs.org/professionals/education/congenital Congenital spinal deformity: http://members.medscape.com/article/1260442-overview


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