Paediatric Surgery (Ukraine). 2024. 3(84): 80-85. doi: 10.15574/PS.2024.3(84).8085
Mezentsev A. O., Petrenko D. E., Demchenko D. O.
Dnipropetrovsk Specialized Clinical Medical Center of Mother and Child named after Professor M.F. Rudnev of Dnipro Regional Council, Ukraine

For citation: Mezentsev AO, Petrenko DE, Demchenko DO. (2024). The results of using thoracoplasty in adolescent idiopathic thoracic scoliosis. Paediatric Surgery (Ukraine). 3(84): 80-85. doi: 10.15574/PS.2024.3(84).8085.
Article received: Jun 04, 2024. Accepted for publication: Sep 09, 2024.

Due to the high efficiency of modern methods of spinal deformity correction and the likelihood of intra- and postoperative complications after thoracoplasty, the frequency of its use has decreased significantly.
Aim – to estimate the results of thoracoplasty after surgical deformity correction in adolescent idiopatic scoliosis.
Materials and methods. A retrospective analysis of the results of 560 patients whit adolescent idiopatic scoliosis, who were operated since 2010 to 2019. Mean age was 14.7 years old. Patients were divided into 5 groups: posterior correction with derotation techniques without using of thoracoplasty (group 1) – 336 patients, posterior correction with derotation techniques with using of thoracoplasty (group 2) – 126 patients, posterior correction with cantilever maneuver with using of thoracoplasty (group 3) – 42 patients, anterior spinal mobilization & posterior correction with derotation techniques with using of thoracoplasty (group 4) – 35 patients, anterior spinal mobilization & posterior correction with cantilever maneuver with using of thoracoplasty (group 5) – 21 patients.
Results. The correction of the main curve after surgical treatment was 50-75%, and the secondary curve correction was 50-80%. The rib hump height after surgical treatment decreases in all groups, especially in patients underwent anterior mobilization as a first stage. Also, apical rib hump prominence index increases in all groups of patients. The results of pulmonary function test after surgical treatment were almost the same or little bite change between 10%. The level of self-assessment by SRS-30 scale increase from 34% to 90%.
Conclusions. Using of thoracoplasty lead to improvement of cosmetic results due to restoration anatomical form of the chest and postoperative results of pulmonary function test after 1 year follow-up were the same as before operation.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of all the institutions mentioned in the study. Informed consent was obtained from the patients.
No conflict of interests was declared by the authors.
Keywords: thoracoplasty, idiopathic scoliosis, anterior spinal mobilization, posterior corrective fusion, pulmonary function.

REFERENCES

1. Duray C, Ilharreborde B, Khalifé M, Julien-Marsollier F, Simon AL, Ferrero E. (2024, Oct). Benefit-risks analysis of thoracoplasty in adolescent idiopathic scoliosis treated by sublaminar bands. Orthop Traumatol Surg Res. 110(6): 103484. Epub 2022 Nov 23. https://doi.org/10.1016/j.otsr.2022.103484; PMid:36435372

2. Greggi T, Bakaloudis G, Fusaro I, Silvestre M. (2010, Dec). Pulmonary function after thoracoplasty in the surgical treatment of adolescent idiopathic scoliosis. Journal Spine Disoders Tech. 23(8): e63-69. https://doi.org/10.1097/BSD.0b013e3181d268b9; PMid:20625329

3. Karami M, IIharrborde B, Morel E. (2007, Oct). Video-assisted thoracoscopic surgery (VATS) for the treatment of scolioticrib hump deformity. European Spine Journal. 16(9): 1373-1377. https://doi.org/10.1007/s00586-007-0340-z; PMid:17356821 PMCid:PMC2200748

4. Kim YJ, Lenke LG, Bridwell KH, Kim KL, Steger-May K. (2005). Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure. J Bone Joint Surg (American). 87: 1534-1541. https://doi.org/10.2106/00004623-200507000-00016

5. Kumar V, Vatkar AJ, Baburaj V, Najar E. (2022). Pulmonary function after thoracoplasty for adolescent idiopathic scliosis: a systematic review and meta-analysis. European Spine Journal. 31: 2972-2986. https://doi.org/10.1007/s00586-022-07375-9; PMid:36069937

6. Liang W, Yu B, Wang Y, Qiu G, Shen J, Zhang J et al. (2016, May 11). Pleural Effusion in Spinal Deformity Correction Surgery- A Report of 28 Cases in a Single Center. PLoS One. 11(5): e0154964. https://doi.org/10.1371/journal.pone.0154964; PMid:27167221 PMCid:PMC4864220

7. Mezentsev AA, Petrenko DE, Barkov A.A. (2007). Otsenka rezultatov khyrurhycheskoho lechenyia skolyoza s pomoshchiu voprosnyka SRS-30. Ortopedyia, travmatolohyia y protezyrovanye. 4: 17-21.

8. Mummaneni P, Sasso R. (2005, Apr). Minimally Invasive, Endoscopic, Internal Thoracoplasty for the Treatment of Scoliotic Rib Hump Deformity: Technical Note Operative Neurosurgery. 56(4): E444. https://doi.org/10.1227/01.NEU.0000157103.15608.82; PMid:15794848

9. Shi Z, Wu Y, Huang J, Zhang Ye. (2013, Nov). Pulmonary function after thoracoplasty and posterior correction for thoracic scoliosis patients. International Journal of Surgery. 11; 9: 1007-1009. https://doi.org/10.1016/j.ijsu.2013.05.035; PMid:23747977

10. Zhu Z, Qui Y, Wang B, Yu Y. (2008, Apr). Thoracic complications of convex thoracoplasty in patients with thoracic scoliosis. Zhonguo Gu ShangActions. 21(4): 249-251.