Three-dimensional computed tomographic volume rendering techniques in endoscopic thoracoplasty.

摘要: Abstract Background context: Thoracoplasty is occasionally necessary to achieve an acceptable cosmetic result in the presence of a rib hump, especially previously fused young adults with scoliosis. This usually requires resection four five segments, and morbidity associated open posterior or anterior by means thoracotomy often considerable, apart from leaving unsightly scar. We thought use endoscopic internal technique would desired less morbidity. Our experience using three-dimensional (3-D) computed tomographic (CT) volume rendering plan our portals releases for scoliosis correction led us believe same techniques could be adapted endoscopically carry out thoracoplasty. Purpose To define utility 3-D CT spine thorax preoperative planning resection. Study design A prospective evaluation patients undergoing thoracoplasty humps. Patient sample Four consecutive scoliotic spines pronounced right-sided humps requiring operative were selected. Outcome measures was assessed at minimum follow-up 6 months clinical examination, patient satisfaction result, repear helical scanning reconstruction. Methods underwent rendering, prior corrective surgery. All had reasons. Using vector plane created mirror left scapula, its intersections on right chest wall noted. The ribs resected marked, length measured plane's intersection points ribs. In this way estimate required final position elevated scapula determined. Entry also estimated lines optimal access each rib. During surgery, portal sites selected Also, extent resections compared estimates. outcome repeat Results male female ratio 1:3, average age 21 years. blood loss 307 ml hospital stay 4.75 days. accurate did provide direct involved deformity. able resect suggested lengths segments matching all cases descend into bed, thus balancing shoulder heights. An excellent achieved as evaluated patient's perception, scanning. Conclusion estimates provides reliable cosmetically hump through minimally invasive techniques.