Short apical rib resections thoracoplasty compared to conventional thoracoplasty in adolescent idiopathic scoliosis surgery

Jae Hyuk Yang, Amit Wasudeo Bhandarkar, Hitesh N. Modi, Si Young Park, Jae Min Cha, Jae-Young Hong, Seung-Woo Suh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: 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.

Original languageEnglish
Pages (from-to)2680-2688
Number of pages9
JournalEuropean Spine Journal
Volume23
Issue number12
DOIs
Publication statusPublished - 2014 Jan 1

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Thoracoplasty
Scoliosis
Ribs
Lung
Lordosis
Kyphosis
Neuralgia

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Short apical rib resections thoracoplasty compared to conventional thoracoplasty in adolescent idiopathic scoliosis surgery. / Yang, Jae Hyuk; Bhandarkar, Amit Wasudeo; Modi, Hitesh N.; Park, Si Young; Cha, Jae Min; Hong, Jae-Young; Suh, Seung-Woo.

In: European Spine Journal, Vol. 23, No. 12, 01.01.2014, p. 2680-2688.

Research output: Contribution to journalArticle

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AU - Yang, Jae Hyuk

AU - Bhandarkar, Amit Wasudeo

AU - Modi, Hitesh N.

AU - Park, Si Young

AU - Cha, Jae Min

AU - Hong, Jae-Young

AU - Suh, Seung-Woo

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N2 - Purpose: 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.

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KW - Rib hump

KW - Scoliosis

KW - Spine

KW - Thoracoplasty

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