May 20, 2005
An 18-month-old girl was the first in the New York City area to receive a titanium rib prosthesis to correct a severe form of congenital curvature – or scoliosis – of her spine that constricts the lung cavity. The condition, known as thoracic insufficiency syndrome, prevents the lungs from fully growing, often leading to death in childhood or early adulthood. The successful procedure, recently performed at Morgan Stanley Children's Hospital of NewYork-Presbyterian, is part of an ongoing clinical trial of the new device.
The recently FDA-approved VEPTR™ (Vertical Expandable Titanium Rib Prosthesis) consists of a telescoping rod with a hook on either end that attaches to the child's ribs, forcing them apart to open the chest cavity. The device not only expands the chest and allows room for lung growth, but it also straightens the spine, thus correcting scoliosis itself.
"Parents and pediatricians alike need to be made aware of this important new treatment option – a new paradigm in the treatment of thoracic insufficiency syndrome," says Dr. David P. Roye, director of pediatric orthopedic surgery at Morgan Stanley Children's Hospital and Livingston Professor of Pediatric Orthopedics at Columbia University College of Physicians and Surgeons. Traditionally, thoracic insufficiency syndrome is treated by fusing together vertebrae of the child's spine; however, this treatment prevents the body from growing, and the lungs from fully developing.
"Compared to traditional spine surgery, the new procedure is relatively straightforward and recovery is much quicker," explains Dr. Michael Vitale, assistant attending orthopedic surgeon at Morgan Stanley Children's Hospital and Herbert Irving Assistant Professor of Pediatric Orthopedic Surgery at Columbia University College of Physicians and Surgeons, who assisted Dr. Roye with the procedure.
Every six months, at least until the child is eight years old, the telescoping mechanism of the prosthesis is adjusted in order to keep pace with the child's growth. These adjustments continue until the child's chest cavity is sufficiently large, usually between the ages of eight and fifteen.
"The child hardly notices the installed prosthesis," says Dr. Roye. "They do not need to wear a brace or a cast, and have no restrictions on normal activities."
Since its inception five years ago, Drs. Roye and Vitale have been members of the Chest Wall and Spine Deformity Core Research Study Group, a 20-member core study group that has overseen development of the device. Both physician-scientists, along with the entire multidisciplinary pediatric orthopedics team at Morgan Stanley Children's Hospital, have extensive experience with similar chest-wall cases.
The VEPTR is manufactured by Synthes Spine of Paoli, Pennsylvania.
Candidates for the prosthesis range in age from six months to six years. Interested parents may call 212-305-5475.
Morgan Stanley Children's Hospital of NewYork-Presbyterian
Ranked by U.S.News & World Report as one of the top five children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics – including the most complex neonatal and critical care, and all areas of pediatric subspecialties – in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children's Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.