Abstract
Purpose: To determine the incidence and outcome of late costoplasty in surgical management of IdS.
Methods and results: A retrospective review of prospectively collected data on patients with IdS who underwent costoplasty after definitive fusion during a 10 year period (1994–2004).
We reviewed surgical records of 318 patients who underwent instrumented spinal fusion for IdS at our centre. Amongst these, 15 patients had undergone late costoplasty. Pre-operative assessment included rib hump measurement, photographs and plain radiographs. 4 patients had computerised tomography to evaluate deformity. Outcome measures included patient satisfaction and clinical evaluation.
Results [Mean (SD)]: Age at primary operation was 12.3(3.3) years; age at costoplasty 17.1(2.7) years. Pre-operative Cobb angle was 64.1 (19.5) and postoperative Cobb 36.9 (15.7) degrees. Median time between primary operation and costoplasty was 4 years. Median follow up was 7 years. Indication for costoplasty was cosmetic deformity with prominent rib hump (n=9) and curve progression (n=6). Approach at primary operation was anterior 1 case, posterior 3 and combined 9 cases. Median length of stay was 5 days.
All patients except 1 had significant reduction in rib hump deformity. Complications included 1 case of surgical scar tenderness, 1 transient neuralgia and 1 patient required a chest drain due to haemothorax.
Discussion: Costoplasty is a cosmetic procedure for the correction of rib prominence in scoliosis. There is low incidence of late costoplasty (i.e. after definitive spinal fusion) in IdS. Following costoplasty, patients were satisfied with their cosmetic appearance; no major complications occurred and no further reoperation was needed.
Ethics approval: Audit/service standard in trust number: 1236
Interest Statement: None
Correspondence should be addressed to BSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
