Evaluation of the role of concave rib osteotomies in the correction of thoracic scoliosis

The role of concave rib osteotomies was studied in a series of 25 patients with right thoracic idiopathic scoliosis who underwent Harrington distraction instrumentation and segmental sublaminar wiring of the thoracic curve. Group I had ten patients with rigid curves who had instrumentation, fusion,...

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Bibliographic Details
Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 1989-05, Vol.14 (5), p.491-495
Main Authors: MANN, D. C, NASH, C. L. JR, WILHAM, M. R, BROWN, R. H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Diseases of the osteoarticular system
Diseases of the spine
Female
Humans
Male
Medical sciences
Orthopedic Fixation Devices
Osteotomy - methods
Ribs - surgery
Scoliosis - surgery
Spinal Fusion
Thoracic Vertebrae - surgery
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Summary:The role of concave rib osteotomies was studied in a series of 25 patients with right thoracic idiopathic scoliosis who underwent Harrington distraction instrumentation and segmental sublaminar wiring of the thoracic curve. Group I had ten patients with rigid curves who had instrumentation, fusion, and segmental concave rib osteotomies. Group II had 15 patients with flexible curves who underwent instrumentation and fusion alone. Preoperative side bending curve reduction averaged 23% in Group I and 49% in Group II. Postoperative correction was similar in both groups with Group I achieving 60% (+/- 10%) overall correction and Group II, 57% (+/- 8%). Group I underwent 56% further reduction from side bending compared with Group II's 12% reduction. It was concluded that if preoperative side bending correction was below 35% of standing curve, curve correction comparable to flexible cases could be achieved through multiple concave rib osteotomies. Neurologic risk was not increased, but there was increased pulmonary morbidity of 30%.
ISSN:0362-2436
1528-1159
DOI:10.1097/00007632-198905000-00003