Vertical expandable prosthetic XXXX rib device insertion: does it improve pulmonary function?

@entity1 @entity15795 @entity2063 @entity1887 @entity1635 @entity281 @entity702 @entity2383
PURPOSE: Vertical expandable prosthetic @entity702 rib (VEPTR) insertion and expansion has been advocated to increase thoracic volume and pulmonary function in @entity1 with @entity1887 . We reviewed our experience with VEPTR implantation to determine if lung function and growth is augmented, to determine the @entity1 's functional status, and if the @entity1635 is controlled. METHODS: From 2006 to 2010, 29 insertions and 57 expansions were performed in 26 @entity1 at our institution. Demographic data were reviewed in conjunction with complications, @entity1635 angles, pulmonary function tests (PFTs), and computed tomography-guided 3D reconstructions to determine lung volumes; and quality of life scores were determined using a modified @entity1635 ( @entity1635 ) questionnaire preoperatively and postoperatively. The groups were also stratified by age (because of lung growth potential), disease ( @entity1635 , @entity2063 , neuromuscular, other @entity2383 ), and sex. Analyses using SPSS (SPSS, Chicago, Ill) were performed with P < .05 considered significant. RESULTS: Each @entity1 underwent 3.03    1.8 surgeries, spending 0.97    1.8 days in the intensive care unit and 4.41    6 days in the hospital for each procedure. Mean age was 90.7    41 months. Of the 36 complications, most were because of @entity281 (12), half requiring operative repair (hardware removal). The average PFT percent predicted values for forced expiratory volume in 1 second, forced vital capacity, and RV were 54.6    22, 58.1    24, and 145.3    112, respectively, preoperatively and 51.8    20, 55.9    20, and 105.6    31, respectively, postoperatively. The lung volumes measured by computed tomography when corrected for age do not increase significantly postoperatively. The mean Cobb measurement for the preoperative major curves was 64.7   and postoperatively was 46.1   for those curves measured preoperatively, for a 29% curve improvement. All postoperative curves had a mean of 56.4   and 58.1   at final follow-up, a 3% curve increase. The @entity1635 scores for @entity1 remained unchanged and no statistical difference was seen from preoperative to postoperative values. No statistically significant difference was seen in complications, @entity15795 (forced expiratory volume in 1 second, forced vital capacity, RV), lung volumes, @entity1635 angles, and @entity1635 scores between sex, age, and disease categories. CONCLUSION: There was mild improvement in @entity1635 angles but no improvement in lung function and volume. @entity1635 scores indicate that the @entity1 have near normal function both before and after VEPTR placement. Pulmonary function, lung volume, and @entity1 subjective assessments did not increase dramatically after VEPTR placement, although @entity1635 angles improved.
