Pulmonary function after thoracoplasty for adolescent idiopathic scoliosis: a systematic review and meta-analysis

Kumar, Vishal; Vatkar, Arvind; Baburaj, Vishnu; Najjar, Elie; Bansal, Parth

doi:10.1007/s00586-022-07375-9

Cited by 2 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The common perioperative complications of thoracoplasty are pneumothorax, haemothorax, and pleural effusion. Permanent damage to pulmonary function is even more worrying 10 . There was a statistically significant decrease in the percent‐predicted forced vital capacity with a mean decrease of 4.84% and a significant decrease in the percent‐predicted forced expiratory volume in 1 s with a mean decrease of 3.92% 10 .…”

Section: Introductionmentioning

confidence: 99%

“…Permanent damage to pulmonary function is even more worrying 10 . There was a statistically significant decrease in the percent‐predicted forced vital capacity with a mean decrease of 4.84% and a significant decrease in the percent‐predicted forced expiratory volume in 1 s with a mean decrease of 3.92% 10 . Therefore, we raised a question: Can the corrective effect of rib hump deformity be further improved through advancements in surgical technique?…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Novel Multiple Screw Distraction Reducer System in the Treatment of Scoliosis with a Severe Rib Hump

Deng,

Wang,

Liu

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

ObjectivesThe treatment of scoliosis with a severe rib hump remains a major challenge. Traditional vertebral rotation techniques are not satisfactory, and thoracoplasty has many pulmonary complications that limit its application. A novel surgical device, the multiple screw distraction reducer (MSDR) system, provides longitudinal distraction during the corrective operation while at the same time providing lateral translation and axial derotation, which may facilitate the correction of a rib hump. This study was performed to investigate the effectiveness of the MSDR system for adolescent idiopathic scoliosis (AIS) with a severe rib hump.MethodsThis was a case‐matched study of patients with retrospectively collected data from our hospital between January 2017 and December 2021. Sixty‐eight patients who underwent one‐stage posterior pedicle screw‐instrumented spinal fusion were matched by the Cobb angle of the main curve and rib hump. All patients underwent a minimum of 2 years of follow‐up. The patients were divided into two groups: the MSDR group (using the MSDR system, n = 34) and the DVR group (using direct vertebral derotation, n = 34). The patients were evaluated for the height of the rib hump, deformity correction, complications, and SRS‐30 scores. The unpaired Student's t‐test and Pearson's χ2‐test were used to compare the outcome measures between the two groups. Multiple linear regression analysis was used to examine the variables that affected the correction of a rib hump.ResultsThe rib hump was 30.21 ± 6.21 mm versus 29.35 ± 6.52 mm (p = 0.583) preoperatively and 9.18 ± 4.06 mm versus 13.82 ± 5.54 mm (p < 0.001) at the last follow‐up in the MSDR and DVR groups, respectively. The correction rates were 70.83% and 53.56%, respectively (p < 0.001). Preoperatively, the main thoracic curve was 58.43° ± 7.97° and 57.84° ± 6.32° (p = 0.736) and was corrected to 10.92° ± 5.47° and 19.14° ± 5.32° (p < 0.001) at last follow‐up in the MSDR and DVR group, respectively. Thoracic kyphosis was restored from 18.24° ± 5.19° and 17.98° ± 5.28° (p = 0.836) in the MSDR and DVR group to 24.59° ± 4.41° and 19.32° ± 4.96° (p < 0.001), respectively. Correction of apical vertebra rotation and translation in the main thoracic curve were significantly better in the MSDR group than in the DVR group (p < 0.05). There was no significant difference in the Lenke type, implant density, estimated blood loss, or follow‐up duration between the two groups, whereas the operation time in the DVR group was significantly less than that in the MSDR group. There were only two minor pulmonary complications in the MSDR group. At the last follow‐up, the MSDR group scored higher in terms of appearance and satisfaction (p < 0.05).ConclusionThe MSDR system, enabling better coronal alignment, thoracic kyphosis, and axial derotation, could be a safe and effective technique for severe rib hump correction in AIS.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Novel Multiple Screw Distraction Reducer System in the Treatment of Scoliosis with a Severe Rib Hump

Deng,

Wang,

Liu

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

show abstract

Surgical Treatment Strategies for Severe and Neglected Spinal Deformities in Children and Adolescents without the Use of Radical Three-Column Osteotomies

Grabala,

Gregorczyk,

Fani

et al. 2024

JCM

View full text Add to dashboard Cite

Background: Severe spinal deformity manifests as a pronounced deviation from the normal curvature of the spine in the frontal, sagittal, and horizontal planes, where the coronal plane curvature exceeds 90 degrees and may coincide with hyperkyphotic deformity. The most severe deformities exhibit rigidity, with flexibility below 30%. If left untreated or improperly treated, these deformities can result in serious complications associated with progression of the curvature. A combination of surgical techniques is frequently employed to attain optimal outcomes and minimize the risk of complications. The overall medical condition of the patient, their capacity to endure extensive procedures, the expertise of the surgeon, and the resources available all play significant roles in determining the course of management. A systematic and thorough review of the relevant literature was conducted utilizing a variety of electronic databases. The primary objective of this study was to scrutinize the surgical techniques commonly employed in complex spine surgeries for the management of severe scoliosis without resection vertebral body techniques, with higher potential risk of major complications, including permanent neurological deficit. Conclusions: Halo-gravity traction, halo femoral traction, and all techniques for releases of the spine (anterior, posterior, or combine), as well as thoracoplasty, have demonstrated significant effectiveness in managing severe and rigid idiopathic scoliosis. The combination of several of these methods can lead to optimal alignment correction without the need to perform high-risk techniques involving three-column osteotomies. Surgeons must customize the indications based on factors such as available resources, characteristics of the deformity, and the patient’s individual profile. Surgical correction of severe scoliosis without vertebral body resection surgeries decreases the potential risks related to neurological and pulmonary complications while providing significant clinical improvement outcomes. The powerful Ponte osteotomy is indicated for severe scoliosis, curves with poor flexibility, for better restoration of hypokyphosis, and decrease of hyperkyphosis. These corrective techniques combined with HGT or temporary internal distraction rods are recommended as viable options for managing individuals with severe rigid spine deformity characteristics. Therefore, they also should be considered and performed by a proficient surgical team. The presence of neuromonitoring is crucial throughout these procedures.

show abstract

Pulmonary function after thoracoplasty for adolescent idiopathic scoliosis: a systematic review and meta-analysis

Cited by 2 publications

References 25 publications

A Novel Multiple Screw Distraction Reducer System in the Treatment of Scoliosis with a Severe Rib Hump

A Novel Multiple Screw Distraction Reducer System in the Treatment of Scoliosis with a Severe Rib Hump

Surgical Treatment Strategies for Severe and Neglected Spinal Deformities in Children and Adolescents without the Use of Radical Three-Column Osteotomies

Contact Info

Product

Resources

About