OBJECTIVE
To compare the rib regeneration in patients with adolescent idiopathic scoliosis (AIS) after convex short length rib resection or conventional thoracoplasty.
METHODS
Between January 2005 and December 2009, 36 patients with Lenke 1 AIS underwent posterior correction, instrumentation, and fusion, and the clinical data were retrospectively analyzed. Conventional thoracoplasty was performed in group A (n=14), convex short length rib resection in group B (n=22). There was no significant difference in gender, age, Cobb angle of major curve, flexibility, and preoperative rib hump between 2 groups (P > 0.05). The standing long-cassette anteroposterior and lateral X-ray films of spine were taken at 3 months, 6 months, 1 year, and 2 years respectively after operation. Rib regeneration classification established by Philips was used to analyze the rib formation.
RESULTS
All patients were followed up 32 months on average (range, 24-48 months). Cobb angle of major curve and rib hump were significantly improved when compared with preoperative values in 2 groups (P < 0.05), and there was no obvious correction loss. At each time point after operation, there was no significant difference in Cobb angle of major curve between 2 groups (P > 0.05), but the rib humb of group B was significantly bigger than that of group A (P < 0.05). The rib regeneration in group B was better than that in group A, showing significant difference (P < 0.05). At 3 months after operation, 80.0% rib regeneration was below grade 4 in group A, and 96.3% rib regeneration reached grade 4 or above in group B. At 2 years after operation, 52.0% and 96.3% rib regeneration reached grade 6 or above in groups A and B, respectively.
CONCLUSION
The rib regeneration in patients with AIS after convex short length rib resection is better than that after conventional thoracoplasty.