Titanium Rib News

June 2005

By Amy Olson
For The Marshfield News-Herald

STEVENS POINT - Kate Rueckert is pretty much like any other 2-year-old girl: She loves princesses and Barbie dolls, and enjoys watching the movie "Ice Age" and playing with her 5-year-old sister, Alexandra.

Occasionally, the two girls quarrel, but it's nothing compared to the fight the tiny toddler has waged since she was born.

Late last month, doctors at the University of Wisconsin Children's Hospital in Madison implanted an artificial rib called a Vertical Expandable Prosthetic Titanium Rib into the Stevens Point girl's chest. The device, referred to as a VEPTR, is designed to help straighten her spine and separate her ribs to leave more space for her lungs to grow and to fill with air with each breath she takes.

The operation was the first of its kind in Wisconsin.

Rueckert was born with a severe case of scoliosis that produced a condition called thoracic insufficiency syndrome, which means her chest could not support normal breathing.

In time, the condition would have prevented her chest from growing normally, thus inhibiting growth of her lungs. That could have put her at risk for recurrent respiratory infections and an early death, said Dr. Ken Noonan, a pediatric orthopedic surgeon who was part of the team that operated on Rueckert.

Lynn Rueckert, Kate's mother, said she and her husband, Jack, did not know there was anything wrong with Kate until she was born. Kate's thumbs were folded into her palms, and the index finger on her left hand was fixed to her palm.

"I was worried she would never use her hands," Lynn Rueckert said. Experts at Childrens' Hospital in Milwaukee told the couple that Kate had a condition called arthrogryposis, which affected her joints and muscles and is associated with Kate's thoracic insufficiency and scoliosis.

Lynn Rueckert, who has a bachelor's degree in nuclear medicine, said she immediately began to research arthrogryposis. She found one book online, ordered it, and when she began reading, she was shocked to learn that those with the condition have a life expectancy of 20 years.

"Actually hearing a number was awful," she said.

As Kate grew, the curvature of her spine made it difficult for her to hold her head up while she tried to crawl; instead she rolled. It also affected Kate's ability to eat, because it squeezed her abdomen. Doctors eventually inserted a feeding tube, through which she receives tube feedings to make sure she gets enough nutrition, Lynn Rueckert said.

Doctors first tried to straighten Kate's spine through a series of body casts. When that failed, Noonan suggested the artificial rib. On Aug. 25, Noonan and other members of the VEPTR team inserted the brace into Kate's tiny body. Four days later, she returned home to Stevens Point.

Three weeks after the operation, she has started to sit up on her own. She appears to be gaining strength, and scoots around the house on her plastic toy fire truck.

Over the next seven years or so, Kate will have surgery every four to six months to expand the artificial rib to accommodate her growth. By the time she's 10 or 11 years old, doctors likely will implant rods to continue straightening Kate's spine.

So far, Kate's doctors and parents are happy with her recovery and progress, but they remain cautiously optimistic abut her condition.

"She's made quite the turnaround since the surgery," said her father, Jack Rueckert.

Noonan said it's tough to predict what Kate's physical abilities will be.

Lynn has no doubt in her mind, however, that her daughter will walk. Kate already is going through the motions as she and her mother walk out to the swingset in the backyard. The other day, she pulled herself up and danced along the couch.

"She's getting stronger and stronger every day," Lynn said.

Noonan said the technology has about a 100 percent complication rate. The follow-up surgeries carry a risk of infection, and the artificial rib can come loose, which could injure the patient.