Department of Orthopaedic Surgery, Korea University Guro Hospital, Guro2-Dong, Guro-Gu, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, Nowon-Gu, Seoul, Republic of Korea.
Spine (Phila Pa 1976). 2020 Feb 1;45(3):177-183. doi: 10.1097/BRS.0000000000003219.
A retrospective study.
The purpose of this study was to evaluate the morphology of rib regeneration and to analyze the influence of demographics and curve characteristics on regeneration potential after thoracoplasty in the treatment of adolescent idiopathic scoliosis (AIS).
Studies on the physiological effects after thoracoplasty have been performed for several decades. However, rib cage anatomical regeneration patterns and reformation have been rarely studied.
A total of 120 AIS patients who underwent thoracoplasty with deformity correction were included. Patients were followed for >12 months and radiographic assessment was done at 3, 6, and 12 months. Conventional or short apical rib resection thoracoplasty was performed and 543 ribs were resected. Demographic and curve parameters were recorded and a rib regeneration classification was used to analyze regeneration. Computed tomography (CT) scan was performed only in selected patients (n = 74).
At end of 3, 6, and 12 months, 23%, 45%, and 60% of the ribs had fused respectively. On multiple logistic regression analysis, age <10 years (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 0.754-16.982), age 11 to 12 years (OR: 2.7, 95% CI: 2.709-31.595), age 13 to 14 years (OR: 6.2, 95% CI: 2.504-15.391), age 15 to 16 years (OR: 4.8, 95% CI: 2.064-11.571), five or more ribs excision (OR: 2.0, 95% CI: 1.294-3.108) enhance regeneration. Lenke type 2 (OR: 0.5, 95% CI: 0.305-0.898) Lenke type 4 (OR: 2.3, 95% CI: 1.033-5.144), and Risser grade (OR: 0.8, 95% CI: 0.694-0.967) had a negative influence on regeneration.
The regeneration potential of the resected ribs after thoracoplasty in AIS patients depends on age, Risser grade, Lenke classification, and number of ribs resected. Age was the single most important factor affecting regeneration.
回顾性研究。
本研究旨在评估肋骨再生的形态，并分析胸廓成形术治疗青少年特发性脊柱侧凸（AIS）后，人口统计学和曲线特征对再生潜力的影响。
几十年来，人们一直在研究胸廓成形术后的生理影响。然而，肋骨解剖学再生模式和重构的研究却很少。
共纳入 120 例接受胸廓成形术矫正畸形的 AIS 患者。患者随访时间>12 个月，在术后 3、6 和 12 个月进行影像学评估。行常规或短顶肋切除术胸廓成形术，切除 543 根肋骨。记录人口统计学和曲线参数，并采用肋骨再生分类分析再生情况。仅对部分患者（n=74）进行 CT 扫描。
术后 3、6 和 12 个月时，分别有 23%、45%和 60%的肋骨融合。多元逻辑回归分析显示，年龄<10 岁（比值比[OR]：3.5，95%置信区间[CI]：0.754-16.982）、年龄 11-12 岁（OR：2.7，95%CI：2.709-31.595）、年龄 13-14 岁（OR：6.2，95%CI：2.504-15.391）、年龄 15-16 岁（OR：4.8，95%CI：2.064-11.571）、切除 5 根以上肋骨（OR：2.0，95%CI：1.294-3.108）会增强再生。Lenke 2 型（OR：0.5，95%CI：0.305-0.898）、Lenke 4 型（OR：2.3，95%CI：1.033-5.144）和 Risser 分级（OR：0.8，95%CI：0.694-0.967）对再生有负面影响。
胸廓成形术后 AIS 患者切除肋骨的再生潜力取决于年龄、Risser 分级、Lenke 分型和切除肋骨的数量。年龄是影响再生的唯一最重要因素。
4 级。
