VEPTR/Spine Growing Instrumentation Procedures Clinical Pathway — ICU and Inpatient
Child Undergoing VEPTR/Spine Growing Instrumentation Procedures
Children with complex progressive congenital spinal, thoracic cage, and rib deformities can be considered for thoracic reconstruction stabilized by spine growing instrumentation or vertical expandable prosthetic titanium rib (VEPTR) devices.
The FDA-approved anatomic groups that present with TIS include:
- Absence of ribs
- Fused ribs and scoliosis
- Hypoplastic thorax
- Scoliosis of neuromuscular, or congenital origin without rib abnormality
The goal of VEPTR/spine growing instrumentation surgery is to obtain the largest, most symmetrical, most functional thorax by skeletal maturity. Providing improved volume of the thorax is the best chance for obtaining adequate lung growth for long-term survival.
Children with congenital and juvenile scoliosis without thoracic insufficiency may undergo bracing and casting before potentially needing surgical intervention with traditional or magnetically expandable growing rods.
Exclusion Criteria for VEPTR/Spine Growing Instrumentation Surgery
- Severe comorbidities such as pulmonary or cardiac disease that prevent performing major
thoracic surgery - Inability to tolerate repetitive surgeries needed to expand the devices
- Allergy to titanium or its alloys