Fusionless Instrumentation Systems for Congenital Scoliosis Expandable Spinal Rods and Vertical Expandable Prosthetic Titanium Rib in the Management of Congenital Spine Deformities in the Growing Child
Review of relevant literature including personal opinions.
To review the current researches investigating the efficacy of growing rod and thoracic expansion techniques in the treatment of congenital spine deformity of young children, and to highlight the contrasting advantages and limitations in the fusionless treatment of progressive congenital scoliosis.
Congenital scoliosis has the potential for severe spinal deformity and thoracic insufficiency syndrome (TIS). Conventional fusion treatments in children tend to shorten the spine further exacerbating trunk shortening and TIS. In the surgical treatment of congenital spinal deformities in young children, while reconstructing the spinal deformity, one should simultaneously pursue preserving the growth potential of the vertebrae, improving the volume, symmetry, and functions of the thorax, and protecting this improvement during the growth. Today, employed in the treatment of spinal deformities of young children, there are 2 deformity reconstruction methods serving these targets: Growing rod technique and vertical expandable prosthetic titanium rib (VEPTR) with or without expansion thoracostomy.
Peer-reviewed research articles and major international meeting presentations were reviewed. Methods were compared in terms of advantages and limitations.
The growing rod technique is a safe and reliable method in the treatment of congenital spine deformity of young children who present some flexibility in the anomalous segment, or when the congenital anomaly involves a vertebral segment too long for resection, or with compensating curve with structural pattern concomitant to the congenital deformity. Expansion thoracostomy and VEPTR are the appropriate choice for severe congenital spine deformity when a large amount of growth remains. Although ventilator dependence is significantly decreasing, thoracic volume and space available for the lung are increased after expansion thoracostomy and VEPTR.
Growing rod technique should be used in patients where the primary problem is at the vertebral column. If the patient has rib fusions and/or TIS has developed, in other words, if the primary problem involves the thoracic cage, expansion thoracostomy and VEPTR should be an appropriate option.
[Show abstract][Hide abstract] ABSTRACT: System splitting problem, also known as controlled system separation problem, is to determine proper splitting points to split the entire interconnected transmission network into islands of load with matched generation when islanding operation of system is unavoidable. It is very difficult because of combinatorial explosion of searching space with the size of power network increasing. This paper proposes a two-phase method to find proper splitting strategies in real time by introducing the graph-model of system splitting problem. The method can narrow down the strategy space by highly efficient OBDD-based algorithm in the first phase and give all proper splitting strategies by power-flow calculation in the second phase. Simulation results on IEEE 30-bus test network shows that this method can quickly (in several seconds) give all proper splitting strategies guaranteeing synchronization, power balance and satisfaction to capacity constraints of transmission lines and other facilities in each island.
Power System Technology, 2002. Proceedings. PowerCon 2002. International Conference on; 02/2002
[Show abstract][Hide abstract] ABSTRACT: The presented work demonstrates preliminary
results on manufacturing and mechanical properties
assessment of pure PLLA and PLLA/TCP composite
plates, as potential candidates for maxillofacial
surgery application. Biodegradable, thermoplastic
polymer poly-L-lactide (PLLA, Biomer) and tricalcium
phosphate (TCP, Fluka) particles were applied for the
samples manufacturing in injection moulding process.
The plates were investigated using universal testing
machine Zwick 1435 – in static tensile and creep tests.
The mechanical properties (tensile strength, Young
modulus, elongation) of the polymer and its composite
were determined and the lifetime, performed with the
scope of their potential application in osteosynthesis,
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