VEPTR™ growing rods for early-onset neuromuscular scoliosis: feasible and effective

Clin Orthop Relat Res. 2011 May;469(5):1335-41. doi: 10.1007/s11999-010-1749-y.


Background: The Vertical Expandable Prosthetic Titanium Rib (VEPTR™; Synthes North America, West Chester, PA) reportedly controls spinal deformity associated with constrictive chest wall conditions.

Questions/purposes: We asked whether spine-to-spine constructs using VEPTR™ instrumentation in combination with standard spinal instrumentation could be deployed to salvage failed rib-to-spine constructs used originally in patients with constricted chest walls and to primarily treat progressive spinal deformity without chest wall abnormalities.

Patients and methods: Fifty patients were treated with VEPTR™ constructs for thoracic insufficiency syndrome at our center between 2001 and 2007. Fourteen of these 50 patients had placement of a spine-to-spine construct using a VEPTR™ implant in combination with standard spinal implants and are the subject of this retrospective review. Five had prior rib-based VEPTR™ or growing implants with an average of two failures before this surgery. Radiographic variables, preceding treatment, complications, and changes in ambulatory status, were recorded. The minimum followup was 2 years (mean, 35 months; range, 2-4 years).

Results: After an average of five expansions in these 14 patients, positive changes were recorded for Cobb angle, T1-S1 height, sagittal balance, and space available for the lung. Complications included two rod fractures, two superficial infections, and one deep infection with rod removal.

Conclusions: VEPTR™ instrumentation as a spine-to-spine growing-rod construct demonstrated ease of implantation and expansion, with complication rates similar to other reported devices. This study suggests growing constructs using VEPTR™ can be used with relatively few complications and extends the potential uses of this instrumentation system.

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Male
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / instrumentation*
  • Prosthesis Design
  • Prosthesis Failure
  • Prosthesis-Related Infections / etiology
  • Radiography
  • Reoperation
  • Retrospective Studies
  • Ribs / growth & development
  • Ribs / surgery*
  • Scoliosis / diagnostic imaging
  • Scoliosis / physiopathology
  • Scoliosis / surgery*
  • Spine / abnormalities
  • Spine / diagnostic imaging
  • Spine / growth & development
  • Spine / surgery*
  • Thoracic Surgical Procedures / adverse effects
  • Thoracic Surgical Procedures / instrumentation*
  • Time Factors
  • Titanium*
  • Treatment Outcome
  • Washington


  • Titanium