U surgeons implanted a titanium “rib” that helps correct chest-wall deformities in children with certain spinal deformities for the first time in Utah on Wednesday. The orthopedic surgeons are also teaching the new surgery to doctors from around the country.
Medical school faculty members and Dr. Robert Campbell, the Texas orthopedist who pioneered the procedure, implanted the Vertical Expandable Prosthetic Titanium Rib (VEPTR) in two children as surgeons from around the country looked on.
The operations are part of the U’s role as one of seven U.S. medical centers evaluating VEPTR and teaching the operation to other surgeons.
U faculty members explained the device and operation in a training session on Tuesday, then scheduled the two surgeries for Wednesday at Primary Children’s Medical Center (PCMC) in Salt Lake City. The U physicians serve on Primary Children’s staff.
The rib is intended to correct problems associated with congenital scoliosis, a spinal deformity that stunts chest-cavity growth and stops the lungs from fully developing to support normal respiration. This results in thoracic insufficiency syndrome (TIS), which in some cases can be life threatening.
“Historically the treatment for this problem has been inadequate,” said Dr. John Smith, professor of orthopedics at the U School of Medicine and one of the physicians who will teach the operation.
Until recently, surgery for congenital scoliosis was limited to spinal fusion, which prevented the deformity from getting worse with growth. The titanium rib not only helps straighten the spine, but also allows for expansion of the chest cavity, giving the lungs room to grow.
The device, introduced by Campbell, is a narrow, titanium I-beam with attachments that grab onto the ribs. The beam is surgically placed in the rib cage with the attachments at the top and bottom of the ribs to help the spine grow straighter. The rib can be lengthened as children grow.
A pilot study conducted by Smith, orthopedic resident Dr. Sohrab Gollogly and Campbell, found that five patients nationwide who already received the titanium rib experienced increased chest volumes of 40 to 60 percent. Smith will present the results of the study at a conference in Switzerland in May.
The U.S. Food and Drug Administration has not yet approved the titanium rib, but Smith expects that will happen within a year.
“Spinal deformities in children are relatively rare, but that doesn’t mean a lot of kids couldn’t benefit from the titanium rib,” Smith said. “We now are evaluating 10 children from the Intermountain region who have severe deformities of the spine and chest wall and could benefit from the surgery.”
Smith is conducting the U’s evaluation of the titanium rib; also contributing are Dr. John Braun, assistant professor of orthopedic surgery; Dr. John Hawkins, professor of cardiothoracic surgery; and Dr. Derek Uchida, associate professor in the pulmonary division of the pediatrics department.
Smith learned the procedure under Campbell in San Antonio, Texas. In addition to the U, other medical centers involved in the evaluation are in Boston, Philadelphia, Pittsburgh, San Antonio, Los Angeles and Seattle.