Abstract
There has been debate in the literature over the years regarding whether
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rib resection, and
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surgical approach have a significant impact on long term respiratory function following corrective surgery in idiopathic scoliosis patients.
We undertook a minimum 10 year review of prospective data in patients who had undergone corrective surgery for idiopathic scoliosis.
Patients had pre-operative, two year (where available) and 10 year follow-up respiratory function tests performed. Variables noted were sex, age at surgery, surgical approach, rib release (simple rib osteotomy, not resection), and percentage correction of curvature. All absolute respiratory function values were converted to percentages relative to a normal population of the same height, sex and age with reference to both arm span and height nomograms thus avoiding the need for a control group. Using accepted statistical norms and appropriate analysis we would be able to confirm a 10% difference in respiratory function.
A literature review was also undertaken as part of this study.
The only statistically significant change in respiratory function was a drop in FVC at 10 years in patients in whom a posterior approach had been used for correction without a rib release. In no other group (by other approach, sex, age, initial curvature, or curvature correction) was there a significant difference in long term respiratory function.
In our study the surgical approach did not have a significant impact on long term respiratory function. Rib release is a safe procedure to undertake as part of scoliosis correction.
Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.
