Pediatric Spine Foundation

Title: Thoracic Insufficiency Syndrome

Authors: N Ramírez, A Devaris , S Arroyo, R L Restrepo, A Cuneo, C A Fernández, P Marrero-Ortiz

Journal: Acta Ortopédica Mexicana

Date: August 01, 2020

Excerpt: This work aims to evaluate all available information on thoracic insufficiency syndrome, mainly related to lung growth, clinical manifestations and physical examination, radiographic and lung function findings, treatments, and complications.

Keywords: Syndrome, children, spine, thorax, treatment

Summary:

Purpose

Thoracic Insufficiency Syndrome means that a patient cannot breathe normally and does not have normal lung growth. Through review of studies already published, this study reviews information on thoracic insufficiency syndrome, to provide a summary of the current tools for doctors to help patients with this condition.

Results

  • The development of the lungs is closely related to the growth of the spine, ribs, and sternum during childhood. Therefore, thoracic insufficiency syndrome (TIS) can be caused by issues in the spine, ribs, and sternum including spinal deformities, general chest deformities, or neuromuscular problems.
  • For a doctor to diagnose TIS, they must perform a physical examination, take x rays, and order pulmonary function tests (PFTs). Patients with this condition can have irregular breathing, shortness of breath, and struggles with lung function. Treatment of TIS should be completed as soon as possible to avoid damage to the lungs.
  • Vertical Expandable Prosthetic Titanium Rib (VEPTR) is a type of treatment for early-onset scoliosis (EOS). The use of VEPTR has shown mixed results in terms of bettering lung function, with unalike findings among different studies. Some VEPTR treatment issues include infections, wound healing issues, bone erosion, and ossification.

Discussion Points

  • The use of Vertical Expandable Prosthetic Titanium Rib (VEPTR) has been a common treatment approach for patients with EOS, but it has some disagreements in medical literature as it has limited success in improving lung function and can cause a lot of issues in the patients.
  • This article encourages the need for more research to create better methods to check on patients and explore different treatment options for Thoracic Insufficiency Syndrome.