Gheorghe Burnei1, Traian-Stefan Gavriliu, Ileana Georgescu, Costel Vlad, Cristian Burnei. 1. Maria Sklodowska Curie Clinical Emergency Hospital for Children, 20, C-tin Brancoveanu Blvd, 041451 Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. Electronic address: mscburnei@yahoo.com.
Abstract
BACKGROUND CONTEXT: Rib agenesis in congenital scoliosis is rarely encountered, and its disposal in the application area of the proximal vertical expandable prosthetic titanium rib (VEPTR) module is a challenge to the orthopedic surgeon. PURPOSE: To present a case in which known treatment methods in early-onset scoliosis were not possible to apply. STUDY DESIGN: Case report. METHODS: A patient aged 1 year and 10 months, presenting a congenital scoliosis with the following characteristics: left T3 hemisegmented hemivertebra, T5-T6-T7 hemivertebral segment, T9, T10 trapezoidal vertebrae, right side I-IV rib agenesis with T1-T2-T4 hemivertebral hypoplasia (T3 agenesis) and bilateral XIIth rib agenesis, and V-VI and VII-VIII-IX fused ribs on the right side. We applied a standard VEPTR in a new construct, vertebra to vertebra. RESULTS: The VEPTR vertebra to vertebra proved to be an efficient and stabile construct after 1.5 years of follow-up and three device distractions in a row. The curve corrected from 100 to 58 Cobb degrees. CONCLUSIONS: We believe that the vertebra-to-vertebra construct with eventual modifications may be a solution in the treatment of early-onset scoliosis needing surgery, which associate rib agenesis in the area where the proximal module has to be applied.
BACKGROUND CONTEXT: Rib agenesis in congenital scoliosis is rarely encountered, and its disposal in the application area of the proximal vertical expandable prosthetic titanium rib (VEPTR) module is a challenge to the orthopedic surgeon. PURPOSE: To present a case in which known treatment methods in early-onset scoliosis were not possible to apply. STUDY DESIGN: Case report. METHODS: A patient aged 1 year and 10 months, presenting a congenital scoliosis with the following characteristics: left T3 hemisegmented hemivertebra, T5-T6-T7 hemivertebral segment, T9, T10 trapezoidal vertebrae, right side I-IV rib agenesis with T1-T2-T4 hemivertebral hypoplasia (T3 agenesis) and bilateral XIIth rib agenesis, and V-VI and VII-VIII-IX fused ribs on the right side. We applied a standard VEPTR in a new construct, vertebra to vertebra. RESULTS: The VEPTR vertebra to vertebra proved to be an efficient and stabile construct after 1.5 years of follow-up and three device distractions in a row. The curve corrected from 100 to 58 Cobb degrees. CONCLUSIONS: We believe that the vertebra-to-vertebra construct with eventual modifications may be a solution in the treatment of early-onset scoliosis needing surgery, which associate rib agenesis in the area where the proximal module has to be applied.