thoracic insufficiency syndrome thoracic insufficiency syndrome thoracic insufficiency syndrome is the inability of the thorax to support normal respiration. it is frequently associated with chest and/or spinal abnormalities. treatment options are limited, but include supportive pulmonary care and surgical options (thoracoplasty and/or implantation of vertical expandable prosthetic titanium rib (veptr) devices). thoracic insufficiency syndromespecialtypulmonology