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Treatment of Thoracic Insufficency Syndrome (TIS) - Boston Children's Hospital

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Published on Jul 25, 2012

Surgeons at Boston Children's Hospital implant a vertical expandable prosthetic titanium rib (VEPTR™) in a pediatric patient during a live webcast. The webcast is part of Boston Children's ongoing effort to bring its cutting edge care and technology to specialists and referring physicians around the world and allow consumers to see the latest and most innovative medical treatments available.

John B. Emans, MD, director of the Division of Spinal Surgery at Boston Children's Hospital and professor of Orthopaedic Surgery at Harvard Medical School, will perform the surgery. Dr. Emans specializes in pediatric spinal deformity and has used the expansion thoracostomy and the VEPTR™ device for the treatment of thoracic insufficiency syndrome (TIS) in 31 children with rib fusions and 38 children overall since 1999.

Moderating the broadcast will be James R. Kasser, MD, Orthopedic surgeon-in-chief and professor of Orthopedic Surgery at Harvard Medical School, and Daniel J. Hedequist, MD, a spinal surgeon at Boston Children's with expertise in congenital spine deformity and experience with titanium rib implantation. Drs. Emans, Kasser and Hedequist will answer e-mail questions from viewers during the live broadcast.

"Chest wall expansion and VEPTR™ insertion with periodic expansions may be the preferable treatment for young children with chest wall deformity and scoliosis because it allows both to continue to grow. A multidisciplinary team and care of the soft tissues are as important as the bony operation itself," says Dr. Emans.

VEPTR™ is used to treat TIS, a condition caused by congenital or early onset scoliosis or by hypoplastic thorax syndromes. Deformities of the chest wall, rib cage and spine developing in young children can restrict lung growth or complicate breathing, resulting in TIS. Traditional treatments of early onset spine and chest wall deformity, such as spinal fusion, focused on the vertebral column deformity and often restricted growth of the spine. The VEPTR™ procedure addresses both chest wall and spine deformity directly.

After initial implantation, the VEPTR™ devices are periodically expanded, allowing growth of spine, chest and lungs. Once implanted, the titanium rib, produced by Synthes, Inc., both stabilizes the spine and expands the rib cage to allow for increased lung space. The degree of expansion may be adjusted during surgery and later in the child's life to accommodate growth.

Boston Children's Hospital is the nation's premier pediatric medical center. Founded in 1869 as a 20-bed hospital for children, today it is a 368-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. More than 100 outpatient specialty clinics are located at Boston Children's. Boston Children's Hospital is the primary pediatric teaching affiliate of Harvard Medical School, home to the world's leading research enterprise at a pediatric hospital, and the largest provider of health care to the children of Massachusetts. For more information about the hospital visit: www.childrenshospital.org.

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