The role of the vertical expandable titanium rib in the treatment of infantile idiopathic scoliosis: early results from a single institution

Abstract

Objectives: Few studies exist on the management of progressive curves in the setting of infantile idiopathic scoliosis. We have performed a retrospective review of our experience treating those patients unresponsive to conservative management with the vertical expandable prosthetic titanium rib.

Methods: We reviewed 8 consecutive patients with infantile idiopathic scoliosis treated at our institution between 2000 and 2009. All patients were screened to ensure that no confounding congenital anomalies or comorbidities contributed to the spinal deformity. Pretreatment, posttreatment, and most recent Cobb angle, sagittal balance, and spinal length, were measured to assess overall curve correction. Patient charts were reviewed for the occurrence of complications.

Results: The average age at the time of surgery was 45.8 months (range: 24 to 84 mo). The average preoperative Cobb angle was 84 degrees (range: 50 to 119 degrees) and showed mean curve correction of 35.1% (range: 20% to 60%) over an average follow-up of 32 months (range: 14 to 45 mo). Spinal height increased a mean of 71 mm (range: 51 to 98 mm) over an average of 4 lengthenings (range: 2 to 7). Three of the patients (37%) experienced minor hardware complications, none experienced a neurologic deficit.

Conclusions: Our results suggest that the vertical expandable prosthetic titanium rib device is a safe and effective treatment option for large-magnitude curves in this unique patient population.

Level of evidence: IV--case series.