Skip to main content

Advertisement

SpringerLink
Log in

The effects of thoracoplasty on immediate post-operative recovery in adolescent idiopathic scoliosis

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

Purpose

The purpose of this study was to evaluate differences in pain, opiate utilization and oxygen (O2) consumption during the immediate post-operative course for patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) with and without thoracoplasty.

Methods

Patients aged 10–21 years old that had undergone PSF for AIS were identified from 1/1/16–8/1/18. A cohort of patients that did not have a thoracoplasty group was used as a control group. A standardized pain protocol (rapid response pathway) was implemented on all patients. A retrospective chart review was performed. Pre-operative, operative and post-operative data and SRS scores were analyzed.

Results

Forty-six patients (38 girls, 8 boys) were included, 23 in each group. The average age was 15.2 years (range 12.0–19.3) and BMI was 20.9 (range 13.1–37.6). Differences in visual analog scores, post-operative oxygen and narcotic consumption were not statistically significant on any POD. Total opiate utilization was 146.06 morphine milligram equivalents (MME) in the control group and 149.41 MME in the thoracoplasty group (p = 0.78). One-year SRS self-image scores were higher in the thoracoplasty group (4.24 vs 3.96) (p = 0.007). There was no difference in length of hospitalization (3.6 vs 3.5 days), levels fused (12.9 vs 12.9) or blood loss (334.1 vs 413.5 mL). There was one pleural effusion and no instances of intercostal neuralgia or pneumothorax in the thoracoplasty group.

Conclusion

There is no increase in immediate post-operative pain, narcotic use or oxygen consumption when a thoracoplasty is performed with a PSF for AIS. Improved SRS self-image scores were seen after thoracoplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Dunn J, Henrikson NB, Morrison CC, Nguyen M, Blasi PR, Lin JS (2018) U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. In: Screening for Adolescent Idiopathic Scoliosis: a systematic evidence review for the U.S. preventive services task force. Agency for healthcare research and quality (US), Rockville (MD),

  2. Soultanis KC, Stavropoulos NA, Grivas TB, Tsiavos K, Starantzis K, Papagelopoulos PJ (2015) Rib hump deformity assessment using the rib index in adolescent idiopathic scoliotics treated with full screw or hybrid constructs: aetiological implications. Scoliosis 10(Suppl 2):S10. https://doi.org/10.1186/1748-7161-10-s2-s10

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wever DJ, Veldhuizen AG, Klein JP, Webb PJ, Nijenbanning G, Cool JC, Horn JR (1999) A biomechanical analysis of the vertebral and rib deformities in structural scoliosis. Eur Spine J: Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 8(4):252–260. https://doi.org/10.1007/s005860050169

    Article  CAS  Google Scholar 

  4. Winter RB, Lonstein JE, Denis F (2007) How much correction is enough? Spine 32(24):2641–2643. https://doi.org/10.1097/BRS.0b013e31815a5207

    Article  PubMed  Google Scholar 

  5. Rushton PR, Grevitt MP (2013) Comparison of untreated adolescent idiopathic scoliosis with normal controls: a review and statistical analysis of the literature. Spine 38(9):778–785. https://doi.org/10.1097/BRS.0b013e31827db418

    Article  PubMed  Google Scholar 

  6. Ward WT, Friel NA, Kenkre TS, Brooks MM, Londino JA, Roach JW (2017) SRS-22r scores in nonoperated adolescent idiopathic scoliosis patients with curves greater than forty degrees. Spine 42(16):1233–1240. https://doi.org/10.1097/brs.0000000000002004

    Article  PubMed  Google Scholar 

  7. Rushton PR, Grevitt MP (2013) What is the effect of surgery on the quality of life of the adolescent with adolescent idiopathic scoliosis? A review and statistical analysis of the literature. Spine 38(9):786–794. https://doi.org/10.1097/BRS.0b013e3182837c95

    Article  PubMed  Google Scholar 

  8. Suk SI, Kim JH, Kim SS, Lee JJ, Han YT (2008) Thoracoplasty in thoracic adolescent idiopathic scoliosis. Spine 33(10):1061–1067. https://doi.org/10.1097/BRS.0b013e31816f2888

    Article  PubMed  Google Scholar 

  9. Newton PO, Perry A, Bastrom TP, Lenke LG, Betz RR, Clements D, D’Andrea L (2007) Predictors of change in postoperative pulmonary function in adolescent idiopathic scoliosis: a prospective study of 254 patients. Spine 32(17):1875–1882. https://doi.org/10.1097/BRS.0b013e31811eab09

    Article  PubMed  Google Scholar 

  10. Clement JL, Chau E, Geoffray A, Suisse G (2014) Restoration of thoracic kyphosis by simultaneous translation on two rods for adolescent idiopathic scoliosis. Eur Spine J: Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 23(Suppl 4):S438-445. https://doi.org/10.1007/s00586-014-3340-9

    Article  Google Scholar 

  11. CDC (2018) 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes - United States. Surveillance Special Report 2. Centers for disease Control and Prevention, U.S. Department of Heath and Human Services. https://www.cdc.gov/drugoverdose/resources/data.html. Accessed August 1st, 2019

  12. Samdani AF, Hwang SW, Miyanji F, Lonner B, Marks MC, Sponseller PD, Newton PO, Cahill PJ, Shufflebarger HL, Betz RR (2012) Direct vertebral body derotation, thoracoplasty, or both: which is better with respect to inclinometer and scoliosis research society-22 scores? Spine 37(14):E849-853. https://doi.org/10.1097/BRS.0b013e31824a4911

    Article  PubMed  Google Scholar 

  13. Lee AC, Feger MA, Singla A, Abel MF (2016) Effect of Surgical Approach on pulmonary function in adolescent idiopathic scoliosis patients: a systemic review and meta-analysis. Spine 41(22):E1343-e1355. https://doi.org/10.1097/brs.0000000000001619

    Article  PubMed  Google Scholar 

  14. Duray C, Ferrero E, Julien-Marsollier F, Simon AL, Michelet D, Mazda K, Ilharreborde B (2019) Pulmonary function after convex thoracoplasty in adolescent idiopathic scoliosis patients treated by posteromedial translation. Spine deformity 7(5):734–740. https://doi.org/10.1016/j.jspd.2019.02.006

    Article  CAS  PubMed  Google Scholar 

  15. Greggi T, Bakaloudis G, Fusaro I, Di Silvestre M, Lolli F, Martikos K, Vommaro F, Barbanti-Brodano G, Cioni A, Giacomini S (2010) Pulmonary function after thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis. Journal of spinal disorders & techniques 23(8):e63-69. https://doi.org/10.1097/BSD.0b013e3181d268b9

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Children’s Hospital of Orange County, Orange, USA

    Benjamin Sherman, Peymon Madi & Afshin Aminian

  2. Riverside University Health System, 26520 Cactus Ave. B2042, Moreno Valley, CA, 92555, USA

    Benjamin Sherman

Authors
  1. Benjamin Sherman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peymon Madi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Afshin Aminian
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. All authors contributed to material preparation, data collection and analysis. The initial draft of the manuscript was written by Benjamin Sherman and all authors revised it critically. All authors read and approved the final manuscript. All authors agree to the accountability of this work.

Corresponding author

Correspondence to Benjamin Sherman.

Ethics declarations

Conflicts of interest

Dr. Aminian is a paid speaker for Medicrea USA, corp. No other authors claim any conflicts of interest.

Ethics approval

Institutional review board approved.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sherman, B., Madi, P. & Aminian, A. The effects of thoracoplasty on immediate post-operative recovery in adolescent idiopathic scoliosis. Eur Spine J 30, 733–739 (2021). https://doi.org/10.1007/s00586-020-06715-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-020-06715-x

Keywords

Search

Navigation