Spine (Phila Pa 1976). 2025 May 19. doi: 10.1097/BRS.0000000000005392. Online ahead of print.
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.
PMID:40384585 | DOI:10.1097/BRS.0000000000005392
