VEPTR Patient Information Brochures: Veptr EnglishVeptr
Vertical Expandable Prosthetic Titanium Rib (VEPTR) is a
device that is used for conditions of the spine and chest wall that
interfere with growth and normal function.
Originally developed by Campbell and Smith in San Antonio, the
device was FDA-approved in 2004 as a Humanitarian Device Exemption
Children's Mercy Hospitals and Clinics has been using the
device since early 2006 when Dr. Campbell helped to launch the
VEPTR program. Synthes Corporation manufactures it and its use is
monitored within the purview of the Institutional Review Board.
Currently we manage more than dozens of patients
with this condition.
The current diagnoses for which VEPTR is used include:
- Jarcho-Levin Syndrome
- Jeune Syndrome
- Ellis van Creveld Syndrome
- Thoracic Insufficiency Syndrome
Thoracic Insufficiency Syndrome is present when the thorax
(ribs, spine and muscles and tissues that hold it together) is
unable to support normal respiration and normal lung growth. To
make the diagnosis of TIS, a history and physical with chest and
spine x-rays, often a CT scan and pulmonary tests are done.
At Children's Mercy Hospital, we assess the potential VEPTR
patient in a multi-disciplinary way. A pediatric pulmonologist and
often a pediatric surgeon will see and assess the patient and help
to determine whether the patient may be helped by VEPTR.
This typically involves an inpatient stay of a few days to a
week. On several occasions pre-operatively the VEPTR team will
review the patient's status and discuss the nature of the surgery.
There are many different techniques possible with VEPTR including
rib-to-rib, rib-to-spine and rib-to-pelvis options.
There is initially a short stay in the ICU. We have found that
most patients do not routinely require a long stay in the ICU; most
are weaned from the ventilator overnight. Some patients, who
require more extensive chest wall surgery, will also require more
breathing support. This may lead to several days on a
Post-operatively, most patients go home on oral pain
medications. Follow-up x-rays are typically taken within a week of
discharge and typically at a six-week follow-up. At six-to-12
monthly intervals, the VEPTR device is lengthened. Initially, the
patient may stay overnight but with familiarity of the patient and
family, and with approval of the surgeon, often the lengthening can
be done as an outpatient.