Objectives:
The purpose of this study is to evaluate the effects of VEPTR on spine growth and deformity improvement, and the complication rates.
Materials and Methods:
In our institute between 2009 and 2011, 12 patients were instrumented with VEPTR without fusion for the treatment of progressive early onset scoliosis. Diagnoses included six patients with congenital scoliosis (five patients had fused ribs), two cases of infantile idiopathic scoliosis, two cases of syndromic scoliosis, one case of neuromuscular scoliosis, and one case of juvenile idiopathic scoliosis. The mean age at the time of surgery was 4.1 (range: 1.6–9) years. The mean duration of follow-up was 1.5 (range: 1–2.5) years. The average number of lengthenings was 3.6 (range: 2–5) per patient. The average interval between lengthenings was 6.9 (range: 5.5–9.5) months. Radiographic evaluation included the measurement of changes of the deformity Cobb angle, the T1–S1 distance, the coronal, sagittal and shoulder balance, and the kyphosis.
Results:
The mean preoperative scoliosis improved from 66° (range: 48–88°) to 52° (range: 32–85°) postoperatively, and was 63° (range: 40–96°) at the last follow-up. The mean total T1–S1 elongation was increased by 1.8 cm per year. Nine of the 12 patients (75%) had 21 complications (1.75 complications per patient) during the treatment period (five distal hook dislodgements, five rib cradle cephalad migrations, five deep wound infections, two rib cradle caudal migrations, two distal screw pull-outs, one crankshaft phenomenon, and one superficial wound infection).
Conclusion:
Spinal deformity (scoliosis and shoulder, coronal and sagittal balance) was not effectively controlled by the VEPTR system in this study. Although this system allows for the continued growth of the spine, it has high complication rates.
Keywords: VEPTR, early onset scoliosis, correction, balance.