Many types of severe or progressive spinal deformities can be safely treated with surgery. Vertical expandable prosthetic titanium Rib (VEPTR) devices are growing rods designed to mechanically stabilize and distract the thorax to correct three-dimensional thoracic deformities. This design allows expansion and anatomic distraction but impose replacement of components through surgery. With the motorized growing rods, elongation occurs without surgery. The aim of this study is to estimate and compare direct medical costs with VEPTR and motorized growing rods. A retrospective study was conducted in pediatric orthopedic surgery department to estimate direct medical costs in 10 children treated with VEPTR technique and 7 children treated with motorized growing rods. Costs collection was conducted over a period of one year. This economic analysis adopted the health care payer’s perspective and took into account hospital stays, medical devices, medical consultations and radiographic examinations. Descriptive analysis of quantitative variables, a mean comparison and a univariate sensitivity analysis were performed. There were 30% of girls in the VEPTR group and 71% in the motorized group. The implantation mean age was 9 years old in VEPTR and 6 years old in the other group. There was more syndromic scoliosis (86% vs. 40%) in motorized growing rods than congenital scoliosis. Average direct medical costs are 21 461€ in VEPTR group vs. 29797€ in motorized growing rods group. The costs associated with medical device are higher in motorized growing rod group. Total costs were equivalent in both groups. However, motorized implants avoid hospital stays for surgery. The costs avoided would be visible if the follow-up after implantation was longer.