Early outcome of vertical expandable prosthetic titanium rib technique in treating early-onset scoliosis
- Author:
- No author available
- Journal Title:
- Chinese Journal of Surgery
- Issue:
- 10
- DOI:
- 10.3760/cma.j.issn.0529-5815.2012.10.005
- Key Word:
- 脊柱侧凸;钛;肋骨;假体和植入物;矫形外科手术;手术后并发症;Scoliosis;Titanium; Ribs;Prostheses and implants; Orthopedic procedures;Postoperative complications
Abstract： Objective To investigate the early outcome of vertical expandable prosthetic titanium rib (VEPTR) technique in treating early-onset scoliosis.Methods This study recruited 11 early-onset scoliosis patients ( 8 boys and 3 girls) who received VEPTR treatment from December 2006 to July 2011 with a minimum follow-up of 12 months.The average age at initial surgery was (7 ±3) years (range,3.1 to 9.8 years). VEPTR device,either rib to rib or rib to lumbar,was implanted at initial surgery. During the regular post-operative follow-ups,expansion surgeries were scheduled at an interval of 6 to 12 months.Measurements of primary curve magnitude,apical vertebral translation,thoracic height and T1-S1 height were performed on radiographs,and were compared between those of preoperatively,postoperatively,and at latest follow-up through paired-t tests.Results All patients had a mean follow-up of (32 ± 11 ) months.Totally 41 surgeries were performed,averagely 3.7 surgeries per patient ; and 30 expansion surgeries were carried out,averagely 2.7 surgeries per patient.The average interval for each expansion surgery was 8 months.From preoperatively to latest follow-up,the Cobb angle of primary curves was averagely corrected from 78° ±18° to 55° ±11° (t =4.931,P ＜ 0.05 ),and apical vertebral translation and thoracic kyphosis displayed slight improvement.Average thoracic height increased from ( 13.3 ± 2.0 ) cm to ( 17.2 ± 2.4 ) cm ( t =8.365,P ＜0.001 ),and average T1-S1 height from ( 24.4 ± 3.8 ) cm to ( 32.5 ± 5.3 ) cm ( t =9.080,P ＜0.001 ).After initial surgery with VEPTR instrumented,gains in thoracic height and T1-S1 height per expansion surgery averaged (0.8 ± 0.3 ) cm and ( 1.8 ± 0.4) cm,respectively.Eight complications occurred in 6 patients,including rib cradle dislodgements,displayed infection,intraoperative pleura rupture and loosening of lumbar pedicle screws. Conclusions VEPTR technique proves to be an effective way of preventing curve progression in early-onset scoliosis patients while allowing growth of spine and chest.Yet,indications for such a technique need to be strictly selected because of the relatively high complication rate.
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