Long-term results of Schollner costoplasty in patients with idiopathic scoliosis

Study Design. A retrospective analysis of patients with idiopathic scoliosis treated with Schollner costoplasty. Objective. To evaluate the long-term effects of Schollner costoplasty on rib hump and respiratory function Summary Background Data. Costoplasty is an established technique to improve chest wall deformity in patients with scoliosis. Concerns have been raised of the long-term effects of costoplasty on respiratory function in adults. No long-term studies of this procedure exist. Methods. A total of 25 patients with idiopathic scoliosis rib hump deformity underwent Schollner costoplasty. There were 12 patients who underwent surgery on the convexity alone, and 13 underwent additional "concave surgery" (6 Silastic (R) [Dow Corning (R) Corp., Midland, MI] implants, 7 concave lengthenings). Five patients underwent simultaneous spinal arthrodesis. The remaining patients underwent delayed procedures ( 0.4-19 years) following the index operation. Vital capacity ( VC) and rib hump were measured before and after surgery, and at each attendance thereafter. Results. Mean follow-up was 10.8 years. Average reduction in rib hump was 38 mm at 6 months and 29 mm at long-term. There was no significant difference in the preoperative and long-term VC ( P = 0.4), although at 6 months after surgery, there was a significant reduction in VC of 5.1%( P = 0.03). Subgroup analysis ( convex only, concave lengthening, concave Silastic (R)) revealed a similar pattern for rib hump correction and maintenance of VC in the long-term for each group. There was no significant difference between adults and adolescents in terms of both the reduction in rib hump and the VC ( P = 0.2 and 0.3) Conclusions. Rib hump correction and lung function are preserved in the long-term following Schollner costoplasty in both adults and adolescents.