European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
Effect of thoracoplasty on patient-reported outcomes in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion: a systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Brigato Paolo, Ouellet Jean Albert, Saran Neil, De Salvatore Sergio, Oggiano Leonardo, Palombi Davide, Sangiovanni Gian Mario, Cardahi Federico, Vadalà Gianluca, Costici Pier Francesco, Papalia Rocco, Denaro Vincenzo
Аннотация
PURPOSE: Adolescent idiopathic scoliosis (AIS) is commonly associated with rib hump (RH) deformity, which poses a significant cosmetic concern for patients. Traditionally, thoracoplasty (TH) has been the preferred treatment to address this issue. This systematic review and meta-analysis evaluates the impact of combining TH with posterior spinal fusion (PSF) compared to PSF alone in AIS surgery. It focuses on patient-reported outcome measures (PROMs), particularly self-image scores, to assess the true cosmetic benefit of incorporating TH into PSF procedures.
METHODS: Following PRISMA guidelines, a systematic review was conducted from inception to March 2025 using Medline, Scopus, Embase, and Cochrane Library. Search terms included "thoracoplasty", "scoliosis", "rib hump", "Scoliosis Research Society Score" and "self-image scores". Outcomes assessed included surgical and radiological metrics, functional outcomes and complications. A meta-analysis was conducted to compare PROMs between patients treated with TH + PSF and those treated with PSF alone. The risk of bias was assessed using the MINORS score.
RESULTS: The 5 included studies had a level of evidence of either 2 or 3, with a total of 599 patients analyzed. Patients who underwent TH + PSF (n = 270) did not exhibit statistically significant differences in functional outcomes, including SRS questionnaire scores for pain, function, mental health, satisfaction, self-image, and overall score, compared to those who underwent PSF alone (n = 329) (p > 0.05). Additionally, the TH + PSF groups experienced an higher rate of postoperative complications compared to the PSF alone groups.
CONCLUSION: The current meta-analysis indicates that TH did not result in significant improvements across any PROMs domains when added to PSF in AIS patients. Further well-conducted randomized controlled trials are needed to refine clinical decision-making by identifying the degree of deformity that may benefit from the addition of TH.
METHODS: Following PRISMA guidelines, a systematic review was conducted from inception to March 2025 using Medline, Scopus, Embase, and Cochrane Library. Search terms included "thoracoplasty", "scoliosis", "rib hump", "Scoliosis Research Society Score" and "self-image scores". Outcomes assessed included surgical and radiological metrics, functional outcomes and complications. A meta-analysis was conducted to compare PROMs between patients treated with TH + PSF and those treated with PSF alone. The risk of bias was assessed using the MINORS score.
RESULTS: The 5 included studies had a level of evidence of either 2 or 3, with a total of 599 patients analyzed. Patients who underwent TH + PSF (n = 270) did not exhibit statistically significant differences in functional outcomes, including SRS questionnaire scores for pain, function, mental health, satisfaction, self-image, and overall score, compared to those who underwent PSF alone (n = 329) (p > 0.05). Additionally, the TH + PSF groups experienced an higher rate of postoperative complications compared to the PSF alone groups.
CONCLUSION: The current meta-analysis indicates that TH did not result in significant improvements across any PROMs domains when added to PSF in AIS patients. Further well-conducted randomized controlled trials are needed to refine clinical decision-making by identifying the degree of deformity that may benefit from the addition of TH.