AI Article Synopsis
- The study aimed to evaluate the midterm outcomes of lateral thoracotomy in skeletally immature children focusing on the development of thoracogenic scoliosis and the extent of lung tissue resection.
- A total of 129 children were analyzed, with findings showing that scoliosis typically developed an average of 5.3 years post-surgery, affecting 28.7% of patients, though no significant risk factors were identified for its occurrence related to surgery age or lung resection extent.
- The findings highlight the need for ongoing monitoring of these patients, as scoliosis can progress years after the initial surgery, even without major spinal deformities noted prior.
Article Abstract
Purpose: To determine the midterm outcome of lateral thoracotomy (LT) in skeletally immature patients concerning thoracogenic scoliosis development and lung parenchyma resection (LPR) extent.
Methods: In total, 129 children met the inclusion criteria: (1) LT during the study period; (2) skeletally immature at the time of LT; (3) clinical and radiographic follow-up of at least 3 years; and (4) no spinal or thoracic deformity on radiographs before LT. Patients were grouped according to their underlying disease, age at LT, and LPR extent. Radiographic parameters were assessed. Kaplan-Meier survival curves and univariate and multivariate analysis were performed.
Results: Of 129, 108 patients underwent pneumonectomy (9; 9.1%), lobectomy (79; 61.2%), segmentectomy (20; 15.5%) and 21 patients LT without LPR. The mean age at LT and at last radiological follow-up was 5.5 years (birth-17.8) and 15.2 years (3.4-33.2). The mean follow-up was 10 years (3-28.1). Scoliosis developed on average 5.3 years after LT. The mean Cobb angle was 22.1° (11-90°); > 10° in 37/129 patients (28.7%), of whom 5/129 (3.9%) had > 45°. The average vertebral rotation was 16.2° (2-43°; grade 0-II). RVAD was 26.5° (8°-33°) and 15.3° (2-43°) in patients with Cobb > 45° and ≤ 45°. Gender, age at surgery, and extent of LPR were not risk factors for post-thoracotomy scoliosis (p > 0.05), although younger patients developed a more severe deformity.
Conclusion: Although post-thoracotomy scoliosis is not associated with significant rotation, the risk of curve progression > 45° is relatively high. Regular follow-up is required as scoliosis may develop several years after LT with or without LPR.
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| http://dx.doi.org/10.1007/s00586-022-07242-7 | DOI Listing |
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