Posterior Spinal Fusion with Rib Resection Allows for Improved Deformity Correction as well as Patient Satisfaction.

IF 2.6 2区医学 Q2 CLINICAL NEUROLOGY

Spine Pub Date : 2025-05-19 DOI:10.1097/BRS.0000000000005392

Vishal Sarwahi, Katherine Eigo, Effat Rahman, Brian Li, Victor Koltenyuk, Sayyida Hasan, Keshin Visahan, Yungtai Lo, Jon-Paul DiMauro, Terry Amaral

{"title":"Posterior Spinal Fusion with Rib Resection Allows for Improved Deformity Correction as well as Patient Satisfaction.","authors":"Vishal Sarwahi, Katherine Eigo, Effat Rahman, Brian Li, Victor Koltenyuk, Sayyida Hasan, Keshin Visahan, Yungtai Lo, Jon-Paul DiMauro, Terry Amaral","doi":"10.1097/BRS.0000000000005392","DOIUrl":null,"url":null,"abstract":"Study design: Retrospective Cohort Study.Objective: This study aimed to compared radiographic and clinical outcomes in Adolescent Idiopathic Scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) with and without thoracoplasty.Summary of background data: Scoliosis is a three-dimensional deformity. As a result, patients often have an associated rib cage deformity, with clinical and aesthetic implications. Direct vertebral rotation (DVR) allows for some reduction of the rib hump; however, the deformed ribs remain deformed. Rib resection has been utilized to further reduce the rib hump, however there are concerns of increased pain, operative time, and blood loss.Methods: Retrospective review of 400 AIS patients undergoing PSF between 2018-2023. Patients were stratified based on those who underwent rib resectioning (RR) and those who did not (Non-Rib Resection, N-RR). Radiographic, surgical, and clinical outcomes were compared. Clinical outcomes were collected utilizing SRS-22 and our institution's activity questionnaire, validated via \"test-retest\" method. All data is presented as medians, IQR, frequencies, and percents. Fisher's Exact, Chi-squared, and Wilcoxon rank-sum tests were used.Results: 153 patients were in the RR group, 247 were in the N-RR. Preoperative rib hump was not statistically significant between the two groups (P=0.49). Final rib hump was 16.3 mm in RR patients and 29.8 mm in N-RR (P<0.001). RR had 60.5% rib hump correction; N-RR had 30.4% correction (P<0.001). Patient reported self-image (P=0.02) and mental health (P=0.01) scores had significantly improved in RR. No differences in 90-day complication rates (P=0.19) or self-reported return to activities (P>0.05).Conclusion: Rib resectioned patients had approximately double the amount of rib hump correction at 60.5%, compared to those who did not undergo rib resectioning at 30.4%, with no increase in the rate of complications. RR patients had improved self-reported self-image and mental health scores, with no difference in timing for return to activities.","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005392","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Study design: Retrospective Cohort Study.

Objective: This study aimed to compared radiographic and clinical outcomes in Adolescent Idiopathic Scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) with and without thoracoplasty.

Summary of background data: Scoliosis is a three-dimensional deformity. As a result, patients often have an associated rib cage deformity, with clinical and aesthetic implications. Direct vertebral rotation (DVR) allows for some reduction of the rib hump; however, the deformed ribs remain deformed. Rib resection has been utilized to further reduce the rib hump, however there are concerns of increased pain, operative time, and blood loss.

Methods: Retrospective review of 400 AIS patients undergoing PSF between 2018-2023. Patients were stratified based on those who underwent rib resectioning (RR) and those who did not (Non-Rib Resection, N-RR). Radiographic, surgical, and clinical outcomes were compared. Clinical outcomes were collected utilizing SRS-22 and our institution's activity questionnaire, validated via "test-retest" method. All data is presented as medians, IQR, frequencies, and percents. Fisher's Exact, Chi-squared, and Wilcoxon rank-sum tests were used.

Results: 153 patients were in the RR group, 247 were in the N-RR. Preoperative rib hump was not statistically significant between the two groups (P=0.49). Final rib hump was 16.3 mm in RR patients and 29.8 mm in N-RR (P<0.001). RR had 60.5% rib hump correction; N-RR had 30.4% correction (P<0.001). Patient reported self-image (P=0.02) and mental health (P=0.01) scores had significantly improved in RR. No differences in 90-day complication rates (P=0.19) or self-reported return to activities (P>0.05).

Conclusion: Rib resectioned patients had approximately double the amount of rib hump correction at 60.5%, compared to those who did not undergo rib resectioning at 30.4%, with no increase in the rate of complications. RR patients had improved self-reported self-image and mental health scores, with no difference in timing for return to activities.

查看原文本刊更多论文

后路脊柱融合术切除肋骨可改善畸形矫正和患者满意度。

研究设计：回顾性队列研究。目的：本研究旨在比较青少年特发性脊柱侧凸（AIS）患者行后路脊柱融合术（PSF）合并胸廓成形术和不合并胸廓成形术的影像学和临床结果。背景资料摘要：脊柱侧凸是一种三维畸形。因此，患者通常伴有胸腔畸形，具有临床和美学意义。直接椎体旋转（DVR）可以减少肋骨隆起；然而，变形的肋骨仍然变形。肋骨切除已被用于进一步减少肋骨隆起，但存在增加疼痛、手术时间和失血的担忧。方法：回顾性分析2018-2023年间400例接受PSF治疗的AIS患者。患者根据接受肋骨切除术（RR）和未接受肋骨切除术（N-RR）的患者进行分层。比较影像学、外科和临床结果。临床结果采用SRS-22问卷和本院活动问卷收集，并采用“重测”法进行验证。所有数据均以中位数、IQR、频率和百分比表示。采用Fisher's Exact、Chi-squared和Wilcoxon秩和检验。结果：RR组153例，N-RR组247例。两组患者术前肋骨驼峰差异无统计学意义（P=0.49）。RR组最终肋骨隆起为16.3 mm， N-RR组最终肋骨隆起为29.8 mm （P0.05）。结论：肋骨切除患者的肋骨驼峰矫正率约为60.5%，是未切除患者的两倍，矫正率为30.4%，且并发症发生率未增加。RR患者自我报告的自我形象和心理健康得分有所改善，但在重返活动的时间上没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Spine 医学-临床神经学

CiteScore

5.90

自引率

6.70%

发文量

361

审稿时长

6.0 months

期刊介绍： Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.