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

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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.

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Acknowledgments

This study was supported by a grant of the Korea Healthcare Technology R&D project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A110416). No benefits in any form have been or will be received from any commercial party related directly or indirectly to the subject of this manuscript. The authors obtained informed consent from the patients prior to the study.

Conflict of interest

None.

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Authors and Affiliations

  1. Scoliosis Research Institute, Department of Orthopedics, Korea University Guro Hospital, 87 Guro-dong, Guro-Gu, Seoul, 152-703, Korea

    Jae Hyuk Yang, Amit Wasudeo Bhandarkar, Hitesh N. Modi & Seung Woo Suh

  2. Department of Orthopedics, Korea University Anam Hospital, Anam-dong 5-ga, Seongbuk-gu, Seoul, 136-705, Korea

    Si Young Park

  3. The Division of Biological Sciences, The University of Chicago, 5801 South Ellis Avenue, Chicago, IL, 60637, USA

    Jae Min Cha

  4. Department of Orthopedics, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan, Gyeonggi, 425-707, Korea

    Jae Young Hong

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  1. Jae Hyuk Yang
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  2. Amit Wasudeo Bhandarkar
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  3. Hitesh N. Modi
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  7. Seung Woo Suh
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Correspondence to Seung Woo Suh.

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Yang, J.H., Bhandarkar, A.W., Modi, H.N. et al. Short apical rib resections thoracoplasty compared to conventional thoracoplasty in adolescent idiopathic scoliosis surgery. Eur Spine J 23, 2680–2688 (2014). https://doi.org/10.1007/s00586-014-3299-6

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  • DOI: https://doi.org/10.1007/s00586-014-3299-6

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