Vertical Expandable Prosthetic Titanium Rib (VEPTR)
Vertical Expandable Prosthetic Titanium Rib (VEPTR)
The Vertical Expandable Prosthetic titanium Rib (VEPTR) mechanically stabilizes and distracts the thorax without fusion in seriously ill, juvenile patients diagnosed with Thoracic Insufficiency Synrome (TIS), TIS is defined as the inability of the thorax to support normal respiration or lung growth. Most commonly, it occurs in patients with severe rib anomalies associated with scoliosis. The overriding clinical need of this patient population is to stabilize their pulmonary condition caused by musculoskeletal deformity and to ultimately allow the continued growth of their thoracic cavity and spine. VEPTR implants are attached perpendicularly to the patients natural ribs and lumbar vertebra or sacrum. Once VEPTR is in place, the design allows for periodic expansion of the thoracic cavity and replacement of component parts through less invasive surgery. Patients are usually very young and must be followed until skeletal maturity. As the patient grows, the VEPTR prosthesis is expanded every 4 to 6 months to accommodate the growth of the child. Eventually the prosthesis must be replaced with a longer device for expansion to continue.
Available constructs are.
The ends of the inferior and superior cradles mate with the ribs. They are available as neutral, angled right, and angled left to best fit rib cradles is T-shaped for enhanced strength. The rib sleeve is the central section of the construct. This acts as a track for the cradles. The distraction locks are inserted into holes at both ends of the construct to attach the superior cradle and either the inferior cradle or the lumbar extension. The position of inferior cradle assembly along the rib sleeve depends on the desired length of the overall rib prosthesis construct. All of these configurations are required to accommodate extensive differences in anatomy that exist in these patients. Associated manual instrumentation is available for distraction, insertion, expansion, and removal of the VEPTR.
- Cradle-to-Cradle (Rib-to-Rib) The Cradle-to-Cradle assembly is available in two different radii, 220 mm and 70 mm, and various lengths.
- Cradle-to-Lumbar Extension (Rib-to-Lumbar Lamina) The Cradle-to-Lumbar Extension is available in 220 mm radius.
- Cradle-to-S Hook (Rib-to-Ilium) The Cradle-to-S Hook Assembly is available in 220 mm radius
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