[Morphologic study on rib regeneration in patients with adolescent idiopathic scoliosis after convex short length rib resection].
摘要
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.