Please clarify me

[Carlos Alberto]

Hi

Please somebody may explain me what are the growing rods?.
I read some posts mentioning this but I always used to think that this growing rods were together with fusion. But in the last post that I read I found the opposite. This last post described a procedure similar to those I read about the VEPTER. Can anybody explain me the difference?
When Gaby was at surgery for posterior fusion of her hemivertebraes and correct her thoracic curve ( 3 years old) she was Luque instrumented with two posterior rods and it seems to me that the doctor used the growing rod name. What I show in the Xrays in this post is what i thought that the growing rod were. For what I read in the last post I must be wrong and I shouldn't know at all what the growing rods are.
Can anybody share an Xray with me for best understanding?

Best regards

[Carmell]

Carlos,

Gaby's photo shows a permanent rod with wiring to hold it in place until the fusion heals (did you mention she had a FAILED fusion?). There is nothing in that xray that would resemble an expandable device.

Growing rods -vs- VEPTR rods... There are various designs of the two devices, and each has their own purpose and usefulness. The typical growing rod is attached on either side of the spine (much like Gaby's xray). The difference is that there is an expandable part in the middle. The top and bottom of the rods are fused to the bone to make it stable. The middle part is expandable (like a car jack - to jack it up and make it longer - in millimeter/centemeter measurements). The growing rods have had some history of stunting spine growth after a couple of years of expansions. No one is certain why this happens (per Dr. Skaggs in LA). The growing rods have been used for more than 15 years and have had some successes where a young child has had more trunk/spine growth than if they did a full fusion at an early age.

The VEPTR device is very different from a growing rod. It is attached by encircling an upper rib at the top (under the shoulderblade) and to either a lower rib (again encircling it) or to a single vertebrae (using a horseshoe hook, no fusion) or to the pelvis (again, a hook attachment, no fusion). The VEPTR device allows the spine to be stable and balanced as well as giving it full opportunity to grow vertically. This is an article that explains in detail the use of the VEPTR device, including a photo of the device: http://www.orthojournalhms.org/html/...uscript-06.htm

http://www.fda.gov/cdrh/mda/docs/h030009.html another site that explains briefly what the VEPTR device is used for.

Each VEPTR patient must meet certain requirements. Only a VEPTR trained surgeon can tell you if Gaby would qualify for this procedure or not. Braydon had his spine fused as an infant (T5-L1). At age 6 he had the VEPTR devices placed (two vertical expandable rods). He will be having his 8th expansion surgery next Thursday (Nov. 10). His quality of life has improved dramatically since having the VEPTR surgery. AGain, this is nothing to take lightly. Surgery is ALWAYS a big deal. You must weigh pros and cons, and have a lengthy discussion with the surgeon about their recommendations. It is something to look into if there are no other options for Gaby.

Take care and I hope this helps a little.

[Carlos Alberto]

news of Gaby

Carmell

Thanks so much for writing. As I supposed I didn't know what were the growing rods surgery at all. I just heard our doc saying that the rod they put to Gaby were able to have a little displacement for allow a little growing or something like that, we talk in Spanish so what I remembered was a translation and it confused me.

When Gaby was one year and four months old she was at surgery for posterior fuse T8-T12 using one inch of my own left tibia as graft and without any hardware. This surgery was failed because an infection with Staphilococus Aureus. She used then a Boston Corset but she evolved really bad I show in this post a preop Xray and photo.
When she was three years old the doctor decided to make the surgery that I showed in my first post. They used autograft and a bioceramic material for fusing hers hemivertebraes. But again the same infection happened. In this point the decision was an antibiotic therapy for resist at least 12 months without removing the hardware for get the posterior fusion of the hemivertebraes. This was so hard for us she was three times in hospital for IV antibiotic treatments. She always responded well to each treatment but a time after the infection increase again because when the bugs get into the rods as rods are an inert body without veins the antibiotic can't disinfect this area. Beside the hardware was loosing strength and almost one rod wound the skin of Gaby. So eight months later the hardware was complete removed. In the surgery, Xrays, and CAT the doctors saw posterior fusion and that the correction of the former surgery was lost. So in this moment she has posterior fusion in the thoracic region.

She was at surgery for remove the hardware at November 26 of 2004. In January she has Xrays and CT scan, in July 2005 she has another Xrays. In the first Xrays the docs measure 78* of kyphosis and 60 * of T Scoliosis. In the second Xray (recent) was 65* Kyphosis and 55* T Scoliosis. So the docs think that the posterior fusion is holding and correcting so we can wait and see for a while with a corset that is between a Boston and Milwaukee 12 to 14 hours per day. We are also making praying therapy of course. This month Gaby is going to have another Xray.

A doctor in the Montreal Children Hospital in Canada evaluated her medical record and told that he thought that VEPTER could help in this case but he can’t assure nothing without see her first. Thanks so much for the webs with information about VEPTER I’m studying this now.