Short apical rib resections thoracoplasty compared to conventional thoracoplasty in adolescent idiopathic scoliosis surgery.
OBJECTIVE
To introduce a modified technique of thoracoplasty (short apical rib resection thoracoplasty (SARRT)) and compare its clinical, functional radiological outcomes and postoperative lung functions with conventional thoracoplasty (CT) in scoliosis surgery.


METHODS
Retrospectively review of adolescent idiopathic scoliosis patients who underwent corrective surgery with thoracoplasty from 2006 to 2010 was performed. Thoracoplasty was performed in 58 patients (CT in 31 and SARRT in 27 patients). 21 patients who underwent deformity correction only, without thoracoplasty were taken as control group (non-thoracoplasty, NT). To evaluate the outcome of SARRT, radiological parameters, pulmonary functions and clinical outcomes were compared among all the three groups.


RESULTS
Age, sex and scoliosis types were evenly distributed between 3 groups (p = 0.66, 0.92, 0.31). Number of levels fused, change in Cobb angle, lordosis, kyphosis, coronal balance, sagittal balance, coronal translation and sagittal translation were not significantly different among the three groups (p > 0.05 for all). There was 38.6% improvement in rib hump in NT, 44.04% in CT and 60.9% correction in SARRT group. Pulmonary complications were significantly higher in the CT group, especially in view of pleural rupture, pulmonary effusion and intercostal neuralgia (p = 0.041, 0.029, 0.049). There was no difference among three groups in postoperative pulmonary function but the score of satisfaction as sub-category in SRS-22 questionnaire was decreased in CT groups (p = 0.046).


CONCLUSIONS
SAART is effective in correcting the rib deformity without altering the pulmonary functions and SAART has less number of pulmonary complications as compared to CT.
Scoliosis Research Institute, Department of Orthopedics, Korea University Guro Hospital, 87 Guro-dong, Guro-Gu, Seoul, 152-703, Korea.
Jae Hyuk
JH
Yang
Amit Wasudeo
AW
Bhandarkar
Hitesh N
HN
Modi
Si Young
SY
Park
Jae Min
JM
Cha
Jae Young
JY
Hong
Seung Woo
SW
Suh
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008141:Lordosis / Q000000981:diagnostic imaging; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011183:Postoperative Complications; D011859:Radiography; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery*; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013905:Thoracoplasty / Q000379:methods*; D016896:Treatment Outcome