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M J Gibson - One of the best experts on this subject based on the ideXlab platform.
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effect on lung functions in patients with thoracic adolescent idiopathic scoliosis treated by posterior spinal fusion with or without Thoracoplasty
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: H Sharma, N Murray, M J GibsonAbstract:Introduction There are controversies in the literature about Thoracoplasty and its effect on lung function changes. The aim of the study was to evaluate the effect and outcome of Thoracoplasty in conjunction with pedicle screw construct in the treatment of thoracic adolescent idiopathic scoliosis on lung functions. Materials and methods It is a retrospective study of consecutive series of 62 patients with thoracic adolescent idiopathic scoliosis surgically treated by single surgeon between 2007 and 2008 at a tertiary referral Orthopaedic Spinal unit. Posterior spinal fusion and Thoracoplasty (n=32, all but one girls) were compared with 30 without Thoracoplasty (all but one girls). Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Absolute and percent-predicted values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC) were evaluated preoperatively and at 3-months, 1 year and/or 2-year follow-up, and comparisons were made between two groups. The minimum follow-up was one year. Results No statistical differences were found between the two groups in PFT9s both pre-operatively and at latest follow up ranging 1 to 3 years. Our findings suggest that Thoracoplasty did not adversely affected long-term PFT9s in AIS patients compared to patients treated by posterior spinal fusion alone. Three-month postoperative pulmonary function test values in both groups experienced 15–30% decline which returned to the preoperative baseline at 1 year in > 90% patients. In Thoracoplasty group, 5 to 8 ribs were resected and used for bone graft. Chest complications were observed in 2 patients requiring chest drainage. Prolonged donor site morbidity was noted in 3 patients. Conclusions Thoracoplasty showed comparable clinical and radiological correction without any significant pulmonary function compromise. Pulmonary function test values returned to the preoperative baseline at 1 year in > 90% patients.
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effect on lung functions in patients with thoracic adolescent idiopathic scoliosis treated by posterior spinal fusion with or without Thoracoplasty
Orthopaedic Proceedings, 2012Co-Authors: H Sharma, N Murray, M J GibsonAbstract:Proponents of Thoracoplasty suggest a better correction, obviating iliac crest donor site morbidity, obtaining bone grafts for fusion and better rib hump correction. Opponents suggest increase risk for chest complications, additional operating time and blood loss, and possible longer hospital stay. There are controversies in the literature about Thoracoplasty and its effect on lung function changes. The aim of the study was to evaluate the effect and outcome of Thoracoplasty in conjunction with pedicle screw construct in the treatment of thoracic adolescent idiopathic scoliosis on lung functions. It is a retrospective study of consecutive series of 62 patients with thoracic adolescent idiopathic scoliosis surgically treated by single surgeon between 2007 and 2008 at a tertiary referral Orthopaedic Spinal unit. Posterior spinal fusion and Thoracoplasty (n=32, all but one girls) were compared with 30 without Thoracoplasty (all but one girls). Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Absolute and percent-predicted values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC) were evaluated preoperatively and at 3-months, 1 year and/or 2-year follow-up, and comparisons were made between two groups. The minimum follow-up was one year. No statistical differences were found between the two groups in PFT9s both pre-operatively and at latest follow up ranging 1 to 3 years. Our findings suggest that Thoracoplasty did not adversely affected long-term PFT9s in AIS patients compared to patients treated by posterior spinal fusion alone. Three-month postoperative pulmonary function test values in both groups experienced 15-30% decline which returned to the preoperative baseline at 1 year in > 90% patients. In Thoracoplasty group, 5 to 8 ribs were resected and used for bone graft. Chest complications were observed in 2 patients requiring chest drainage. Prolonged donor site morbidity was noted in 3 patients. Thoracoplasty showed comparable clinical and radiological correction without any significant pulmonary function compromise. Pulmonary function test values returned to the preoperative baseline at 1 year in > 90% patients.
Stefano Giacomini - One of the best experts on this subject based on the ideXlab platform.
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Thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis.
Studies in health technology and informatics, 2020Co-Authors: Tiziana Greggi, G. Bakaloudis, Francesco Lolli, Konstantinos Martikos, Francesco Vommaro, A. Cioni, Stefano Giacomini, Di Silvestre M, Barbanti Brodano G, P. ParisiniAbstract:Abstract A consecutive series of 40 adolescents surgically treated between 1998-2001, by posterior spinal fusion and Thoracoplasty were compared with a similar group of 40 adolescents treated in the same period by posterior only segmental fusion. Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Minimum five years follow-up was requested. No statistical differences were found between the two groups in PFT's both pre-operatively and at latest follow up. Our findings suggest that Thoracoplasty did not adversely affected long-term PFT's in AIS patients treated by posterior spinal fusion alone.
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Pulmonary function after Thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis.
Journal of Spinal Disorders & Techniques, 2010Co-Authors: Tiziana Greggi, G. Bakaloudis, Isabella Fusaro, Mario Di Silvestre, Francesco Lolli, Konstantinos Martikos, Francesco Vommaro, Giovanni Barbanti-brodano, A. Cioni, Stefano GiacominiAbstract:STUDY DESIGN: Retrospective case series review. OBJECTIVE: To compare two similar groups of adolescents surgically treated for their spinal deformity either by posterior segmental fusion alone (PSF) or by posterior spinal fusion and Thoracoplasty (PSF+T); attention was focused on the long-term effects of Thoracoplasty on pulmonary function in the surgical treatment of adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Posterior spinal arthrodesis with Thoracoplasty and an open anterior approach, with respect to a posterior only fusion have been found to have a deleterious effect on pulmonary function for as long as five years postoperatively after surgical treatment of adolescent idiopathic scoliosis. METHODS: A group of 40 consecutive adolescent patients, surgically treated between 1998 and 2001 by posterior spinal fusion and Thoracoplasty, was compared with a similar cohort of 40 adolescents treated in the same period by posterior segmental fusion alone. Pedicle screw instrumentation alone and a minimum five-year follow-up were requested as inclusion criteria. Both a radiographic analysis and a chart review was performed, evaluating the pulmonary function tests (PFTs), the SRS-30 score questionnaire and the Lenke classification system. A radiographic Rib Hump (RH) assessment was also performed. RESULTS: The entire series was reviewed at an average clinical follow-up of 8.3 years. There were no statistically significant differences between the two groups in terms of gender, age (PSF+T: 16.3 y vs. PSF: 15.2 y), Lenke curve type classification and preoperative Cobb's main thoracic (MT) curve magnitude (PSF+T: 66° vs. PSF: 63°), whereas both final MT percent correction (PSF+T: 53.03% vs. PSF: 51.35%; P
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pulmonary function after Thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis
Journal of Spinal Disorders & Techniques, 2010Co-Authors: Tiziana Greggi, G. Bakaloudis, Isabella Fusaro, Mario Di Silvestre, Francesco Lolli, Konstantinos Martikos, Francesco Vommaro, A. Cioni, Giovanni Barbantibrodano, Stefano GiacominiAbstract:STUDY DESIGN: Retrospective case series review. OBJECTIVE: To compare two similar groups of adolescents surgically treated for their spinal deformity either by posterior segmental fusion alone (PSF) or by posterior spinal fusion and Thoracoplasty (PSF+T); attention was focused on the long-term effects of Thoracoplasty on pulmonary function in the surgical treatment of adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: Posterior spinal arthrodesis with Thoracoplasty and an open anterior approach, with respect to a posterior only fusion have been found to have a deleterious effect on pulmonary function for as long as five years postoperatively after surgical treatment of adolescent idiopathic scoliosis. METHODS: A group of 40 consecutive adolescent patients, surgically treated between 1998 and 2001 by posterior spinal fusion and Thoracoplasty, was compared with a similar cohort of 40 adolescents treated in the same period by posterior segmental fusion alone. Pedicle screw instrumentation alone and a minimum five-year follow-up were requested as inclusion criteria. Both a radiographic analysis and a chart review was performed, evaluating the pulmonary function tests (PFTs), the SRS-30 score questionnaire and the Lenke classification system. A radiographic Rib Hump (RH) assessment was also performed. RESULTS: The entire series was reviewed at an average clinical follow-up of 8.3 years. There were no statistically significant differences between the two groups in terms of gender, age (PSF+T: 16.3 y vs. PSF: 15.2 y), Lenke curve type classification and preoperative Cobb's main thoracic (MT) curve magnitude (PSF+T: 66° vs. PSF: 63°), whereas both final MT percent correction (PSF+T: 53.03% vs. PSF: 51.35%; P<0.03), RH absolute correction (PSF+T: -2.1 cm vs. PSF: -1.05; P<0.01) and RH overall percent correction (PSF+T: 55.4% vs. PSF: 35.4%; P<0.0001) were greater in the Thoracoplasty group. No statistical differences were observed between the two groups in PFTs both pre-operatively and at last follow-up. Nevertheless, comparing preoperative to final PFT'S within each group, only in the PSF group both forced vital capacity and forced expiratory volume in one second showed a statistically significant improvement at final evaluation. At last follow-up visit, the SRS-30 scores did not show any statistical difference between the two groups (total score PSF+T: 4.1 vs. PSF: 4.3). CONCLUSIONS: Our findings suggest that Thoracoplasty did not adversely affect long-term PFTs in AIS patients treated by posterior spinal fusion alone using pedicle screws instrumentation, as already highlighted by previous reports. A trend towards better coronal plane correction and rib hump improvement was seen, although not clearly reported in a self-assessment disease-specific questionnaire.
Jae Hyuk Yang - One of the best experts on this subject based on the ideXlab platform.
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Rib Regeneration Morphology After Thoracoplasty in Adolescent Idiopathic Scoliosis.
Spine, 2020Co-Authors: Jae Hyuk Yang, Dong-gune ChangAbstract:STUDY DESIGN A retrospective study. OBJECTIVE The purpose of this study was to evaluate the morphology of rib regeneration and to analyze the influence of demographics and curve characteristics on regeneration potential after Thoracoplasty in the treatment of adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA Studies on the physiological effects after Thoracoplasty have been performed for several decades. However, rib cage anatomical regeneration patterns and reformation have been rarely studied. METHODS A total of 120 AIS patients who underwent Thoracoplasty with deformity correction were included. Patients were followed for >12 months and radiographic assessment was done at 3, 6, and 12 months. Conventional or short apical rib resection Thoracoplasty was performed and 543 ribs were resected. Demographic and curve parameters were recorded and a rib regeneration classification was used to analyze regeneration. Computed tomography (CT) scan was performed only in selected patients (n = 74). RESULTS At end of 3, 6, and 12 months, 23%, 45%, and 60% of the ribs had fused respectively. On multiple logistic regression analysis, age
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rib regeneration morphology after Thoracoplasty in adolescent idiopathic scoliosis
Spine, 2020Co-Authors: Jae Hyuk Yang, Dong-gune ChangAbstract:STUDY DESIGN A retrospective study. OBJECTIVE The purpose of this study was to evaluate the morphology of rib regeneration and to analyze the influence of demographics and curve characteristics on regeneration potential after Thoracoplasty in the treatment of adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA Studies on the physiological effects after Thoracoplasty have been performed for several decades. However, rib cage anatomical regeneration patterns and reformation have been rarely studied. METHODS A total of 120 AIS patients who underwent Thoracoplasty with deformity correction were included. Patients were followed for >12 months and radiographic assessment was done at 3, 6, and 12 months. Conventional or short apical rib resection Thoracoplasty was performed and 543 ribs were resected. Demographic and curve parameters were recorded and a rib regeneration classification was used to analyze regeneration. Computed tomography (CT) scan was performed only in selected patients (n = 74). RESULTS At end of 3, 6, and 12 months, 23%, 45%, and 60% of the ribs had fused respectively. On multiple logistic regression analysis, age <10 years (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 0.754-16.982), age 11 to 12 years (OR: 2.7, 95% CI: 2.709-31.595), age 13 to 14 years (OR: 6.2, 95% CI: 2.504-15.391), age 15 to 16 years (OR: 4.8, 95% CI: 2.064-11.571), five or more ribs excision (OR: 2.0, 95% CI: 1.294-3.108) enhance regeneration. Lenke type 2 (OR: 0.5, 95% CI: 0.305-0.898) Lenke type 4 (OR: 2.3, 95% CI: 1.033-5.144), and Risser grade (OR: 0.8, 95% CI: 0.694-0.967) had a negative influence on regeneration. CONCLUSION The regeneration potential of the resected ribs after Thoracoplasty in AIS patients depends on age, Risser grade, Lenke classification, and number of ribs resected. Age was the single most important factor affecting regeneration. LEVEL OF EVIDENCE 4.
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short apical rib resections Thoracoplasty compared to conventional Thoracoplasty in adolescent idiopathic scoliosis surgery
European Spine Journal, 2014Co-Authors: Jae Hyuk Yang, Amit Wasudeo Bhandarkar, Hitesh N Modi, Si Young Park, Jae Young HongAbstract: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.
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isolated percutaneous Thoracoplasty procedure for skeletally mature adolescent idiopathic scoliosis patients with rib deformity as their only concern short term outcomes
Spine, 2013Co-Authors: Jae Hyuk Yang, Amit Wasudeo Bhandarkar, Hitesh N Modi, Jae Young Hong, Niraj Sharad Kasat, Jin Ho HwangAbstract:STUDY DESIGN: Prospective case series study. OBJECTIVE: To study the effect of percutaneous Thoracoplasty-only procedure on curve pattern in mature adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: The rib hump prominence on the convex side is the major cosmetic concern among patients with AIS. Thoracoplasty combined with spinal fusion is a commonly used procedure in scoliosis. However, there are no studies regarding the effect of isolated Thoracoplasty procedure on curve pattern in skeletally matured patients with AIS. METHODS: The study involved 7 skeletally matured female patients with AIS. The convex rib hump deformity was measured preoperatively using hump height and hump angle. We performed Thoracoplasty without spinal fusion in patients with the Cobb angle less than 40° but with prominent hump deformity. Thoracoplasty was performed percutaneously using 1 or 2 transverse incisions along the rib hump, and apex portions of the deformed ribs were resected. The Cobb angle was measured before surgery, immediately after surgery, and at final follow-up visit. In all cases, clinical satisfaction was assessed using the Scoliosis Research Society Instrument (SRS-22 questionnaires) and trunk appearance perception scale before surgery and at final follow-up visit. RESULTS: The mean patient age was 20.24 years and an average of 4 ribs were resected. The mean preoperative hump height and hump angle of 38.14 mm and 14.14° improved to 11.70 mm and 11.42° respectively, after surgery (P = 0.018 and 0.042). Preoperative and the final follow-up mean Cobb angles were 35.43° and 45.00°, respectively (P = 0.028). On average, the mean thoracic curve progressed by 9.57°. Preoperative Scoliosis Research Society Instrument SRS-22 questionnaires and trunk appearance perception scale scores of 4.09 and 2.57 respectively improved to and 4.26 and 3.66 after surgery (P = 0.126 and 0.014). CONCLUSION: Percutaneous Thoracoplasty-only procedure gives significant rib humps correction and satisfactory clinical outcome. However, progression of the curve was observed after surgery. This suggests that the convex ribs function as a buttress for curve progression.
Frederik Hahn - One of the best experts on this subject based on the ideXlab platform.
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Primary Thoracoplasty and pedicle screw instrumentation in thoracic idiopathic scoliosis.
European Spine Journal, 2005Co-Authors: Beat Waelchli, Frederik HahnAbstract:Thoracoplasty in combination with spine fusion is an established method to address the rib cage deformity in idiopathic scoliosis. Most reports about Thoracoplasty and scoliosis correction focused on Harrington or CD instrumentation. We report a retrospective analysis of 21 consecutive patients, who were treated with pedicle screw instrumentation for idiopathic thoracic scoliosis and concomitant Thoracoplasty. Minimal follow up was 24 (24–75) months. Indication for Thoracoplasty was clinical rib prominence of more than 15°. In average there was a 44% correction of clinical rib hump, from 18 (15–25°) to 10° (0–18°) (p
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primary Thoracoplasty and pedicle screw instrumentation in thoracic idiopathic scoliosis
European Spine Journal, 2005Co-Authors: Beat Waelchli, Frederik HahnAbstract:Thoracoplasty in combination with spine fusion is an established method to address the rib cage deformity in idiopathic scoliosis. Most reports about Thoracoplasty and scoliosis correction focused on Harrington or CD instrumentation. We report a retrospective analysis of 21 consecutive patients, who were treated with pedicle screw instrumentation for idiopathic thoracic scoliosis and concomitant Thoracoplasty. Minimal follow up was 24 (24–75) months. Indication for Thoracoplasty was clinical rib prominence of more than 15°. In average there was a 44% correction of clinical rib hump, from 18 (15–25°) to 10° (0–18°) (p<0.0001) and a 40% correction of radiological rib hump, from 15 (5–20°) to 9°(2–15°) (p<0.0001). The preoperative pulmonary function, accessed by forced vital capacity (FVC) and one-second forced expiratory volume (FEV1), remained unchanged at the last follow up. The distal end of fusion was the end vertebra of the curve in 83.3% and the end vertebra plus one in 16.7% of the patients. There was a 68% correction of instrumented primary thoracic curves, from 60 (45–85°) to 19°(5–36°) (p<0.0001), and a 45% correction of non-instrumented secondary lumbar curves, from 40 (28–60°) to 22°(8–38°) (p<0.0001). Apical vertebral rotation (AVR) of the thoracic curves improved 54%, from 24 (10–35°) to 11° (5–20°) (p<0.0001). The tilt of lowest instrumented vertebra (LIV) improved 68%, from 28 (20–42°) to 9°(3–20°) (p<0.0001). There was no significant change in sagittal profile of the spine. Analysis with SRS-24 questionnaire showed that the majority of the patients were very satisfied with the outcome. A matched control group (n=21) operated by the same surgeon with the same operation technique but without concomitant Thoracoplasty was chosen for comparison. The scoliosis correction in the two groups was comparable. The patients without Thoracoplasty had 37% spontaneous improvement of the clinical rib hump.
H Sharma - One of the best experts on this subject based on the ideXlab platform.
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effect on lung functions in patients with thoracic adolescent idiopathic scoliosis treated by posterior spinal fusion with or without Thoracoplasty
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: H Sharma, N Murray, M J GibsonAbstract:Introduction There are controversies in the literature about Thoracoplasty and its effect on lung function changes. The aim of the study was to evaluate the effect and outcome of Thoracoplasty in conjunction with pedicle screw construct in the treatment of thoracic adolescent idiopathic scoliosis on lung functions. Materials and methods It is a retrospective study of consecutive series of 62 patients with thoracic adolescent idiopathic scoliosis surgically treated by single surgeon between 2007 and 2008 at a tertiary referral Orthopaedic Spinal unit. Posterior spinal fusion and Thoracoplasty (n=32, all but one girls) were compared with 30 without Thoracoplasty (all but one girls). Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Absolute and percent-predicted values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC) were evaluated preoperatively and at 3-months, 1 year and/or 2-year follow-up, and comparisons were made between two groups. The minimum follow-up was one year. Results No statistical differences were found between the two groups in PFT9s both pre-operatively and at latest follow up ranging 1 to 3 years. Our findings suggest that Thoracoplasty did not adversely affected long-term PFT9s in AIS patients compared to patients treated by posterior spinal fusion alone. Three-month postoperative pulmonary function test values in both groups experienced 15–30% decline which returned to the preoperative baseline at 1 year in > 90% patients. In Thoracoplasty group, 5 to 8 ribs were resected and used for bone graft. Chest complications were observed in 2 patients requiring chest drainage. Prolonged donor site morbidity was noted in 3 patients. Conclusions Thoracoplasty showed comparable clinical and radiological correction without any significant pulmonary function compromise. Pulmonary function test values returned to the preoperative baseline at 1 year in > 90% patients.
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effect on lung functions in patients with thoracic adolescent idiopathic scoliosis treated by posterior spinal fusion with or without Thoracoplasty
Orthopaedic Proceedings, 2012Co-Authors: H Sharma, N Murray, M J GibsonAbstract:Proponents of Thoracoplasty suggest a better correction, obviating iliac crest donor site morbidity, obtaining bone grafts for fusion and better rib hump correction. Opponents suggest increase risk for chest complications, additional operating time and blood loss, and possible longer hospital stay. There are controversies in the literature about Thoracoplasty and its effect on lung function changes. The aim of the study was to evaluate the effect and outcome of Thoracoplasty in conjunction with pedicle screw construct in the treatment of thoracic adolescent idiopathic scoliosis on lung functions. It is a retrospective study of consecutive series of 62 patients with thoracic adolescent idiopathic scoliosis surgically treated by single surgeon between 2007 and 2008 at a tertiary referral Orthopaedic Spinal unit. Posterior spinal fusion and Thoracoplasty (n=32, all but one girls) were compared with 30 without Thoracoplasty (all but one girls). Clinical and radiographic analysis was performed, including the SRS-30 questionnaire and Pulmonary Function Tests (PFT). Absolute and percent-predicted values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and total lung capacity (TLC) were evaluated preoperatively and at 3-months, 1 year and/or 2-year follow-up, and comparisons were made between two groups. The minimum follow-up was one year. No statistical differences were found between the two groups in PFT9s both pre-operatively and at latest follow up ranging 1 to 3 years. Our findings suggest that Thoracoplasty did not adversely affected long-term PFT9s in AIS patients compared to patients treated by posterior spinal fusion alone. Three-month postoperative pulmonary function test values in both groups experienced 15-30% decline which returned to the preoperative baseline at 1 year in > 90% patients. In Thoracoplasty group, 5 to 8 ribs were resected and used for bone graft. Chest complications were observed in 2 patients requiring chest drainage. Prolonged donor site morbidity was noted in 3 patients. Thoracoplasty showed comparable clinical and radiological correction without any significant pulmonary function compromise. Pulmonary function test values returned to the preoperative baseline at 1 year in > 90% patients.
