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Effect of Multi Rib Osteotomy on Pulmonary Functions after Correction of Adolescent Scoliosis: E‐Poster #207

Hamed, Abla M.; El Hawary, Youssry

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Spine Journal Meeting Abstracts: 2010 - Volume - Issue - p 130
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Summary: Rib osteotomy technique is used for giving more flexibility of the spine during correction. However, it leads to chest cage disruption and affection of pulmonary functions

Introduction: Rib osteotomy technique is used for giving more flexibility of the spine during correction especially in severe and rigid curves. However,rib osteotomy leads to a type of chest cage disruption and affection of pulmonary functions

Methods: A prospective study of 50 patients who underwent posterior spinal fusion for correction of adolescent scoliosis. Patients were divided according to number of ribs osteotomy into two groups.Groupl (n=16) who underwent posterior fusion in addition to rib osteotomy from 1‐3 ribs,while group2(n=34)who had rib osteotomy from 4‐6 ribs. All patients were evaluated regarding pulmonary functions and Cobb's angle preoperatively, post operatively, one year and two years post operatively. All patients received pulmonary rehabilitation program from one week postoperative till one years post operative

Results: Curve correction: The mean Cobb's angle at the preoperative and final follow up for group 1 was 72.9±22.9 degree and 11.2±3.9degree respectively(85%correction). In group2it was75.7±21.7 degree preoperatively and 18.3±10.9 degrees at final follow up(76% correction).Pulmonary functions:Pre operatively there was no significant difference between2groups. Immediately postoperative there was significant reduction regarding FVC by about39%in group 1 and69% in group2.Another significant reduction was observed in MVV by about 60% in both groups.One year post operative FVC showed significant improvement in group1 by 57%while in group2 It was 28%.MVV showed another significant improvement by about72% and 54% in group1 and 2 respectively.Two years post operative showed no mean improvement in both groups which not exceeded 6%improvement

Conclusion: Multi rib osteotomy more than3 ribs has a negative effect on pulmonary function extended till one year postoperative even with application of pulmonary rehabilitation program. However, rib osteotomy from 1‐3 ribs has a negative effect just immediately postoperatively which converted at 1 and 2 years post operative

Significance: Rib osteotomy technique has a positive significant effect on curve correction however it has severe negative effect on pulmonary functions especially with osteotomy for more than3 ribs. Pulmonary rehabilitation program has positive significant effect on improving pulmonary functions

© 2010 Lippincott Williams & Wilkins, Inc.