Client News: Florida Hospital Pediatric Orthopaedic Surgeon Performs Rare, Life-Saving Procedure Using a Titanium Rib

Source: Florida Hospital Press Release

Dr. Woo implants the titanium rib on 2-year-old Logan to help save his life by expanding his rib cage.

Two-year-old Logan Gould has been in and out of hospitals his entire life. He was born with a rare condition called Thoracic Insufficiency Syndrome (TIS), which means his chest cavity, or thorax, cannot support normal respiration or lung growth, and can cause life-threatening breathing problems. Some of the abnormalities associated with TIS include rib fusion and scoliosis, or a crooked spine. After dozens of trips to the hospital, the Gould family came to see Dr. Raymund Woo, a pediatric orthopaedic surgeon at Florida Hospital for Children, who offered them the option of inserting a titanium rib to help save Logan.

Dr. Woo is one of a handful of surgeons across the United States who performs expansion thoracostomy and insertion of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) device. The goal of this operation is to provide the rib cage and lungs more space and room to grow.

"Logan has been so sick his entire life, and his rib cage is severely deformed," said Erin Gould, Logan's mother. "We talked about going to Boston or Texas to have the procedure performed. But when we heard Dr. Woo was performing this unique procedure, we felt extremely blessed to be closer to home to get this life-saving procedure for Logan."

The VEPTR device, which is curved to fit the back of the chest and spine, is inserted vertically against the spine to help keep the chest wall expanded. The device also helps to straighten the spine and make it grow in a more normal way. As the child grows, the device can be made longer by performing a simple outpatient procedure. This is typically done twice a year until the child reaches skeletal maturity.

"Each child with TIS comes with a unique combination of medical problems but under the right circumstances, the VEPTR device can be life-saving," said Dr. Raymund Woo, medical director of pediatric orthopaedics at the Walt Disney Pavilion at Florida Hospital for Children. "In addition to getting the VEPTR device implanted, my patients also receive a multidisciplinary approach to make sure they are well cared for before, during and after their stay in the hospital. This team includes a pulmonologist, cardiologist, nutritionist, intensivist, anesthesiologist and surgeon."

The insertion of the VEPTR device does pose several risks including infection from multiple surgeries, drifting of the Titanium Rib, or weakening of skin around the incision site. But to many parents, including Erin Gould, the benefits far outweigh the risks.

"He now has the chance to live a normal life," said Erin. "His quality of life will be so much better and I am so thankful for that."