The treatment of vertebral and chest wall deformities with expandable thoracoplasty and a prosthetic expandable implant.

Abstract

Expansion thoracoplasty is a temporary solution to allow complete pulomonary development in the setting of vertebral and rib cage deformities. After thoracoplasty, an expandable implant is needed to maintain the correction. The Growing Spine Profiler (GSP) is a new type of readjustable rib distracter. The purpose of this study was to evaluate the experiences of surgeons in Europe with the implantation of the GSP. We retrospectively reviewed 44 patients that underwent placement of the GSP at 15 sites throughout Europe. The mean age at the time of surgery was 6.24 years. Basic demographic data and postoperative management were reviewed. All patients received an opening-wedge thoracostomy with device implantation and expansion thoracoplasty. Retrospectively, the original indications for implantation were determined. Digital images of the radiographs were used to measure coronal and sagittal parameters. The most common diagnoses for implantation were hemivertebrae (9), hemivertebrae with chest wall deformity (10), and unilateral bar (8). Outcomes were available for 43 patients with a mean follow-up period of 3.07 years. There were 23 patients that had an adverse event. Rib fractures were the most common adverse event, with 8 incidents in 7 patients. Radiographically, coronal curve magnitudes were maintained, whereas sagittal kyphosis gradually increased. The GSP was effective in the maintenance of deformity, while providing a moderate complication rate. Further studies need to be performed to determine the safety and efficacy of this implant.