Das Problem der Ossifikation und Implantat-Wanderung nach VEPTR (vertical expandable prosthetic titanium rib)-Implantation bei Kindern und Jugendlichen mit Thorax-Insuffizienz-Syndrom und Skoliose

Das Problem der Ossifikation und Implantat-Wanderung nach VEPTR (vertical expandable prosthetic titanium rib)-Implantation bei Kindern und Jugendlichen mit Thorax-Insuffizienz-Syndrom und Skoliose

The problem of ossification and implant-migration after VEPTR (vertical expandable prosthetic titanium rib)-implantation at children and adolescent with thoracic insufficiency syndrome and scoliosis

Bastian Grönefeld

Doctoral thesis

Date of Examination: 2012-08-13

Date of issue: 2012-06-26

Advisor: Hell, Anna-Kathrin Prof. Dr.

Referee: Hell, Anna-Kathrin Prof. Dr.

Referee: Ludwig, Hans-Christoph Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-000D-EFD8-C

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Abstract

English

Until now it was postulated - without scientific verification - that patients with VEPTR (vertical expandable prosthetic titanium rib) treatment get later and less ossifications than children with growing rod treatment because of the lower manipulation at the spinal column. This study is performed to evaluate the ossification rate, time of onset of ossifications, magnitude of ossifications in the course of treatment, correlations for the occurrence of ossifications for putative factors (underlying disease etc.) and potential consequences of ossifications in patients with VEPTR treatment. Fifty-seven patients had a primary longitudinal lengthening with use of a chest-wall distractor known as VEPTR. Repeat lengthenings of the prosthesis were performed at intervals of three to fourteen months. The mean age at the time of the primary operation was 7.7 years (range 1.3 to 18.3), the mean duration of follow-up was 29.8 months (range 1 to 101) and the mean number of operations was 5.9 (range 1 to 19). 1328 spine radiographs were analyzed with respect to the growth of ossifications and implant-migration respectively -avulsion and other complications/radiological parameters. The digital radiographs were measured with Centricity

Keywords: scoliosis; VEPTR (vertical expandable prosthetic titanium rib); ossification; implant-migration; thoracic insufficiency syndrome; children

Schlagwörter: Skoliose; VEPTR (vertical expandable prosthetic titanium rib); Ossifikation; Implantat-Wanderung; Thorax-Insuffizienz-Syndrom; Kinder