Abstract
To evaluate the effect of a vertical expandable prosthetic titanium rib (VEPTR) on shoulder balance in patients with congenital scoliosis. Fifteen patients had a thoracic congenital scoliosis. The Cobb angles of the thoracic primary curves were measured. Preoperative measurements of the coracoid height difference (CHD; expressed in millimeters) and the clavicular tilt angle difference (CTAD; expressed in degrees) were performed for all patients. All of the patients were treated with VEPTR open wedge thoracostomy. There was a statistically significant improvement in thoracic Cobb angle. At the end of follow-up there was a significant improvement in CHD; all but three of the patients had CHD<9mm. Preoperatively, CTAD was 8.9°. It improved to 4.4° postoperatively and significantly decreased to 3.9° by the end of follow-up. Complications included device migration (one patient), infection (one patient), and pedicle screw loosening or displacement (two patients). VEPTR is able to produce a modest intraoperative correction of shoulder imbalance.
Highlights
The prevalence rate of congenital scoliosis is thought to be approximately 1 in 1,000 live births [1]
At the end of follow-up there was a significant improvement in coracoid height difference (CHD); all but three of the patients had CHD \ 9 mm
The clavicular tilt angle difference (CTAD) is a new radiological parameter that has been created in order to assess shoulder balance
Summary
Fifteen patients had a thoracic congenital scoliosis. The Cobb angles of the thoracic primary curves were measured. Preoperative measurements of the coracoid height difference (CHD; expressed in millimeters) and the clavicular tilt angle difference (CTAD; expressed in degrees) were performed for all patients. All of the patients were treated with VEPTR open wedge thoracostomy
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