Introduction Convex hemiepiphyseodesis is still a reasonable option to
treat young patients with congenital scoliosis taking away growth from the
convexity. This study aims to clarify, if growth of the concavity can be
established by the VEPTR method even after convex hemiepiphyseodesis.
Material and Methods 3 patients, 2 girls and 1 boy, had VEPTR surgery at
an average of 4 years after thoracic convex hemiepiphyseodesis as the
index procedure. Follow up was from 6 months to 4 + 6 years. The age at
the time of surgery was 8–9 years.
Results Main thoracic curves corrected from 51
to 37
, from 55
to 44
, and
from 40
to 36
, respectively. Mean secondary lumbar curves improved
from 32
to 20
and from 24
to 20
.
For 1 patientwho had 3VEPTR devices implanted, 1 rib had to be removed
due to an infected skin slough without compromizing the final result. All
patients were treated without a brace. Sport activities were encouraged.
Discussion Convex hemiepiphyseodesis reduces the risk of progression of
congenital scoliosis but may lead to thoracic insufficiency syndrome later
due to impaired longitudinal and latitudinal growth of the thorax. In this
limited case study we were able to show that VEPTR may improve pulmonary
function of congenital curves by induction of concave growth
even after convex hemiepiphyseodesis.