title: The effect of a vertical expandable prosthetic titanium rib on shoulder balance in patients with congenital scoliosis.
abstract: OBJECTIVE
  To evaluate the effect of a vertical expandable prosthetic titanium rib (VEPTR) on shoulder balance in patients with congenital scoliosis.
  
  
  METHODS
  Fifteen patients had a thoracic congenital scoliosis. The Cobb angles of the thoracic primary curves were measured. Preoperative measurements of the coracoid height difference (CHD; expressed in millimeters) and the clavicular tilt angle difference (CTAD; expressed in degrees) were performed for all patients. All of the patients were treated with VEPTR open wedge thoracostomy.
  
  
  RESULTS
  There was a statistically significant improvement in thoracic Cobb angle. At the end of follow-up there was a significant improvement in CHD; all but three of the patients had CHD < 9 mm. Preoperatively, CTAD was 8.9°. It improved to 4.4° postoperatively and significantly decreased to 3.9° by the end of follow-up. Complications included device migration (one patient), infection (one patient), and pedicle screw loosening or displacement (two patients).
  
  
  CONCLUSIONS
  VEPTR is able to produce a modest intraoperative correction of shoulder imbalance.
authors.affiliation: Orthopaedic Department, King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia.
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Samy
authors.forename: Zayed Saleh
authors.initials: ZS
authors.lastname: Al Zayed
authors.forename: Mahmood Farouk
authors.initials: MF
authors.lastname: Shaheen