Smith John T, Jerman Jonathan, Stringham Jack, Smith Melissa S, Gollogy Sohrab
University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
J Pediatr Orthop. 2009 Dec;29(8):944-7. doi: 10.1097/BPO.0b013e3181c11977.
Expansion thoracoplasty using the Vertical Expandable Prosthetic Titanium Rib increases the measured height and volume of the concave hemi thorax, but the effect on the convex, non-instrumented lung is unknown. The purpose of this study was to measure changes in lung volume and density in the convex lung after expansion thoracoplasty.
The volume and density of the lungs was measured in 12 children with congenital scoliosis and fused ribs before and after concave expansion thoracoplasty using serial computed tomography scans.
There were 8 boys and 4 girls with an average age of 6.4 years at initial implant. The average length of follow-up was 17.5 months. All patients showed increased total lung volumes by an average of 250 cc (range 24 to 795 cc). The volume of the concave lung increased by an average of 55% and the lung density decreased by an average of 6%. The volume of the convex lung increased by an average of 60%, and the density decreased by an average of 7%. Nine of 12 patients showed improvement in density of the convex lung.
These findings suggest that concave expansion thoracoplasty increases overall lung volume in children with congenital scoliosis and fused ribs as measured by computed tomography scan. In addition, expansion thoracoplasty seems to have a beneficial effect on the convex, non-operated hemi thorax. Decreases in measured lung density suggest improved aeration of the lung, which may prove to be beneficial to overall pulmonary function.
Level 4 therapeutic studies: case series.
使用垂直可扩展人工钛肋骨进行扩张胸廓成形术可增加凹陷半侧胸廓的测量高度和容积，但对凸出的、未植入器械的肺的影响尚不清楚。本研究的目的是测量扩张胸廓成形术后凸出肺的肺容积和密度变化。
使用系列计算机断层扫描，测量12例先天性脊柱侧弯并肋骨融合患儿在凹陷扩张胸廓成形术前、后的肺容积和密度。
初始植入时，有8名男孩和4名女孩，平均年龄6.4岁。平均随访时间为17.5个月。所有患者的总肺容积平均增加250立方厘米（范围为24至795立方厘米）。凹陷侧肺容积平均增加55%，肺密度平均降低6%。凸出侧肺容积平均增加60%，密度平均降低7%。12例患者中有9例凸出侧肺密度有所改善。
这些发现表明，通过计算机断层扫描测量，凹陷扩张胸廓成形术可增加先天性脊柱侧弯并肋骨融合患儿的总体肺容积。此外，扩张胸廓成形术似乎对凸出的、未手术的半侧胸廓有有益影响。测量的肺密度降低表明肺通气改善，这可能对整体肺功能有益。
4级治疗性研究：病例系列。
