Vertical Expandable Prosthetic Titanium Rib

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Thoracic scoliosis due to Diastematomyelia and Myelomeningocele (MMC) in a 10-year-old boy VEPTR 2010-01-cut.jpeg
Thoracic scoliosis due to Diastematomyelia and Myelomeningocele (MMC) in a 10-year-old boy

Vertical Expandable Prosthetic Titanium Ribs (VEPTR) is a product of Synthes for the treatment of childhood deformities of the thorax. [1] [2] [3] [4] It is a special form of a lengthenable rod ("Growing Rod"). An alternative system is the USS pediatric for older children, also from Synthes.

The instrument is used to dilate a too small or too narrow rib thorax in severe thoracic deformity. It consists of a telescopic "titanium rib" in curved form with several holes in a row for fixing in the desired length. A prolongation can be carried out after 6 months. The fixation takes place between two ribs or between a rib and the iliac crest. This results in an indirect erection of the deformed spine, resulting in an increase in the volume of the thoracic cavity along with the lung.

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In vertebrate anatomy, ribs are the long curved bones which form the rib cage, part of the axial skeleton. In most tetrapods, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax. In some animals, especially snakes, ribs may provide support and protection for the entire body.

Rib cage is a "box" created of ribs, that protects the vital organs and great vessels

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Thorax Frontal part of an animals body, between its head and abdomen

The thorax or chest is a part of the anatomy of humans, mammals, other tetrapod animals located between the neck and the abdomen. In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions of the creature's body, each of which is in turn composed of multiple segments.

Thoracic duct

In human anatomy, the thoracic duct is the larger of the two lymph ducts of the lymphatic system. It is also known as the left lymphatic duct, alimentary duct, chyliferous duct, and Van Hoorne's canal. The other duct is the right lymphatic duct. The thoracic duct carries chyle, a liquid containing both lymph and emulsified fats, rather than pure lymph. It also collects most of the lymph in the body other than from the right thorax, arm, head, and neck. The thoracic duct usually starts from the level of the twelfth thoracic vertebrae (T12) and extends to the root of the neck. It drains into the systemic (blood) circulation at the junction of the left subclavian and internal jugular veins, at the commencement of the brachiocephalic vein.

Thoracic diaphragm Sheet of internal skeletal muscle

The thoracic diaphragm, or simply the diaphragm, is a sheet of internal skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm is the most important muscle of respiration, and separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity: as the diaphragm contracts, the volume of the thoracic cavity increases, creating a negative pressure there, which draws air into the lungs. Its high oxygen consumption is noted by the many mitochondria and capillaries present; more than in any other skeletal muscle.

Pectus excavatum Congenital deformity of the chest

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Childrens Hospital of Eastern Ontario Hospital in Ontario, Canada

CHEO is a pediatric health-care and research centre located in Ottawa, Ontario, Canada. CHEO is also a tertiary trauma centre for children in Eastern Ontario, Nunavut, Northern Ontario and the Outaouais region of Quebec and one of only seven Level I trauma centres for children in Canada. It is affiliated with The Ottawa Hospital and the University of Ottawa, and is funded by the provincial Government of Ontario. CHEO first opened its doors on May 17, 1974, and is located at 401 Smyth Road, Ottawa, Ontario.

Serratus anterior muscle Muscle on the surface of the ribs

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Transversus thoracis muscle

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Internal intercostal muscles

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Intercostal nerves

The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation.

Abdomen Part of the body between the chest and pelvis

The abdomen is the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the front part of the abdominal segment of the torso. The area occupied by the abdomen is called the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax.

Scheuermanns disease Medical condition

Scheuermann's disease is a self-limiting skeletal disorder of childhood. Scheuermann's disease describes a condition where the vertebrae grow unevenly with respect to the sagittal plane; that is, the posterior angle is often greater than the anterior. This uneven growth results in the signature "wedging" shape of the vertebrae, causing kyphosis. It is named after Danish surgeon Holger Scheuermann.

Spondylocostal dysostosis Axial skeleton growth disorder

Spondylocostal dysostosis, also known as Jarcho-Levin syndrome (JLS), is a rare, heritable axial skeleton growth disorder. It is characterized by widespread and sometimes severe malformations of the vertebral column and ribs, shortened thorax, and moderate to severe scoliosis and kyphosis. Individuals with Jarcho-Levin typically appear to have a short trunk and neck, with arms appearing relatively long in comparison, and a slightly protuberant abdomen. Severely affected individuals may have life-threatening pulmonary complications due to deformities of the thorax. The syndrome was first described by Saul Jarcho and Paul M. Levin at Johns Hopkins University in 1938.

Thoracic insufficiency syndrome is the inability of the thorax to support normal respiration. It is frequently associated with chest and/or spinal abnormalities. Treatment options are limited, but include supportive pulmonary care and surgical options.

Asphyxiating thoracic dysplasia Medical condition

Asphyxiating thoracic dysplasia (ATD), also known as Jeune syndrome, is a rare inherited bone growth disorder that primarily affects the thoracic region. It was first described in 1955 by the French pediatrician Mathis Jeune. Common signs and symptoms can include a narrow chest, short ribs, shortened bones in the arms and legs, short stature, and extra fingers and toes (polydactyly). The restricted growth and expansion of the lungs caused by this disorder results in life-threatening breathing difficulties; occurring in 1 in every 100,000-130,000 live births in the United States.

Vertebral column Bony structure found in vertebrates

The vertebral column, also known as the backbone or spine, is part of the axial skeleton. The vertebral column is the defining characteristic of a vertebrate in which the notochord found in all chordates has been replaced by a segmented series of bone: vertebrae separated by intervertebral discs. The vertebral column houses the spinal canal, a cavity that encloses and protects the spinal cord.

Vertebra Bone in the vertebral column

In the vertebrate spinal column, each vertebra is an irregular bone with a complex structure composed of bone and some hyaline cartilage, the proportions of which vary according to the segment of the backbone and the species of vertebrate.

Pulmonary pleurae Serous membrane that lines the wall of thoracic cavity and the surface of lung

The pulmonary pleurae are the two opposing layers of serous membrane overlying the lungs and the inside of the surrounding chest walls.

References

  1. Vertical Expandable Prosthetic Titanium Rib (VEPTR)
  2. VEPTR and VEPTR II Vertical Expandable Prosthetic Titanium Rib
  3. Vertical Expandable Prosthetic Titanium Rib (VEPTR)
  4. VEPTR