• Michał Latalski, Marek Fatyga, and Andrzej Gregosiewicz.
• Paediatric Orthopaedics Department Prof. F Skubiszewski Memorial Medical University in Lublin, Poland. michall1@o2.pl
• Ortop Traumatol Rehabil. 2007 Sep 1; 9 (5): 459-66.

BackgroundSevere deformities of the chest, early-onset progressive scoliosis, congenital defects of the ribs and the vertebral column may all give rise to the thoracic insufficiency syndrome (TIS), when the chest capacity is too low to fully support basic vital functions, leading to gradually progressive cardiopulmonary failure. Aim of study. This paper presents new possibilities for sequential correction of progressive deformities of the thorax and spinal column in skeletally immature children using a vertical expandable prosthetic titanium rib (VEPTR) system.Material And MethodsAt the Department of Pediatric Orthopedics of the Medical University in Lublin, three children were treated surgically with VEPTR, a low-profile modular system allowing simultaneous correction of scoliosis and chest deformities. Two children (aged 8 and 9 years) required treatment for multiple congenital spinal deformities, while one (aged 7) had early progressive neuromuscular scoliosis.DiscussionExisting surgical approaches based on the Harrington method do not prevent further progression of chest deformity. The ongoing sequential VEPTR treatment of our patients resulted in significant correction of thoracic and spinal deformities already in the first phase of the treatment, with considerably improved respiratory capacity.ConclusionThe vertical expandable prosthetic titanium rib appears to be the best alternative to other approaches to sequential treatment of chest and spine deformities currently in use.

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