Document Type
Article
Publication Date
2021
Publisher
Elsevier
Source Publication
Spine Deformity
Source ISSN
2212-134x
Abstract
Study design
Retrospective review of prospective multi-center cohort.
Objective
To investigate the impact of thoracoplasty on pulmonary function at 2-year follow-up among complex pediatric spine deformity patients.
Summary of background data
Complex pediatric spine deformities may be associated with significant rib prominence causing body image concerns. Surgical correction of spine deformity may include thoracoplasty to correct the rotational prominence. Some surgeons refrain from performing thoracoplasty due to its purported negative effect on pulmonary function. There is paucity of literature on the effect of thoracoplasty on pulmonary function at 2-year follow-up in pediatric patients with complex spine deformity.
Methods
We reviewed data of 312 patients (> 100°, with or without vertebral column resection (VCR)) or (< 100° with VCR)) from an international multicenter database. Data of 106 patients with complete radiographic and pulmonary function test (PFT) assessment with a minimum of 2-year follow-up was analyzed. Paired t test was performed to compare pre-op and 2-year PFT results. PFT comparison was stratified based on thoracoplasty status (thoracoplasty: Group 1 vs. no thoracoplasty: Group 2).
Results
106 patients (61 patients Group 1 vs. 45 in Group 2). The average age and gender ratio were similar in both groups (p > 0.05). Group 1 had significantly lower body mass index (BMI) compared to Group 2 (18.4 kg m−2 ± 2.8 vs. 19.9 kg m−2 ± 4.8, p = 0.0351). The average baseline coronal and sagittal Cobbs were larger for Group 1 relative to Group 2 (p < 0.05). The distribution of deformity etiology and curve types, and apices were similar between the two groups (p > 0.05). The rate of pre-op utilization of halo gravity traction (HGT) was 52.5% vs. 26.7% (p = 0.008), at an average duration of 103 days vs. 47 days, p = 0.0001. The rate of surgical osteotomies was similar in both groups. Estimated blood volume (EBV) loss was greater in Group 1 (63.1% vs. 43.1%, p = 0.0012). Post-op coronal and sagittal Cobb correction was similar in both groups. The incidence of post-op pulmonary complication was similar in both groups (8.2% vs. 8.9%, p = 0.899). Baseline and 2-year follow-up PFT did not differ significantly between and within the groups. Vertebral column resection (VCR) did not negatively affect PFT in both groups.
Conclusion
Despite higher curve magnitudes in patients undergoing surgical correction and thoracoplasty for complex pediatric spine deformity, our findings revealed that thoracoplasty does not negatively affect pulmonary function at 2-year follow-up.
Recommended Citation
Boachie-Adjei, Oheneba; Sackeyfio, Arthur; Duah, Henry Ofori; Lenke, Lawrence G.; Sponseller, Paul; Sucato, Daniel J.; Samdani, Amer F.; Newton, Peter; Shah, Suken; Erickson, Mark A.; Wulff, Irene; Sides, Brenda; Gupta, Munish; and Fox Pediatric Spinal Deformity Study, "Does Thoracoplasty Adversely Affect Lung Function in Complex Pediatric Spine Deformity? A 2-Year Follow-Up Review" (2021). College of Nursing Faculty Research and Publications. 1169.
https://epublications.marquette.edu/nursing_fac/1169
Comments
Accepted version. Spine Deformity, Vol. 9 (2021): 105-111. DOI. © 2021 Scoliosis Research Society. Used with permission.
Henry Duah was affiliated with FOCOS Orthopedic Hospital, Accra, Ghana at the time of publication.