AbstractObjective To explore the efficacy of spine-rib distraction on congenital scoliosis (CS) associated with thoracic insufficiency syndrome (TIS). Methods Medical records of twenty-five CS patients (6 boys and 19 girls) with TIS who had undergone spine-rib distraction in our hospital between March 2003 and March 2012 were reviewed. Spine-to-rib distraction devices were implanted during the initial surgery. During the regular post-operative follow-ups, expansion surgeries were scheduled at an interval of 6 to 12 months. Measurements of primary curve magnitude, apical vertebral translation (AVT), thoracic height (T1-T12) and space available for the lung (SAL) were performed on radiographs preoperatively, postoperatively, and during the last follow-up, and were compared through paired t tests. Results Of preoperativepulmonary function tests were collected and compared with those of the last follow-up. ResultsTwenty-five patients had an average follow-up of 86.3 months (ranging from 61 to 122 months). A total of 183 expansion surgeries were performed, an average of 7.3 surgeries per patient. Preoperatively, postoperatively and during the last follow-up, the Cobb angle of the primary curve was 75.5±21.1°, 54.0±15.5°, and 53.2 ± 16.0°respectively, while AVT was 42.9±14.5 mm, 19.7±8.3 mm, and 20.6±9.2 mm respectively. According to the last follow-up, T1-T12 height improved significantly (15.8±2.1 to 21.4±3.0 cm), so did SAL (73.3% to 88.6%). VCmax and FVC measured during the last follow-up were increased significantly compared to preoperative ones(0.87 to 0.99; 0.84 to 0.98,P<0.05). Conclusions Spine-rib distraction technique proves to be an effective treatment for preventing curve progression in CS patients with TIS while ensuring the growth of the spine, symmetry of the chest, and improvement of pulmonary function.
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