Abstract:

Purpose: Rib abnormality at concavity of the curve is one of the frequently seen anomalies in congenital scoliosis. These rib anomalies and fusions at the concave site can negatively effect the correction and maintenance of the curve. The aim of this study is to detect the effects of rib anomalies on correction. Method: 42 congenital scoliosis patients (13 male, 29 female) who had surgery at our hospital between 1995 and 2008 w ere retrospectively evaluated. The mean age was 11 (2-34), and mean follow up period was 63 months (6-144 months). Most of the rib anomalies were fusions that were seen at the same level of the vertebral anomalies. The surgical methods were; hemivertebrectomy with hemiepiphysiodesis at concave site in 16 patients, hemivertebrectomy with posterior fusion in 1 patients, combined anterior and posterior fusion in 5 patients, posterior fusion in 12 patients, posterior hemiepiphysiodesis and hemiarthrodesis in 5 patients and posterior instrumentation without fusion in 3 patients. Whereas 18 patients w ere operated at one stage, 24 patients had additional surgeries. Findings: When the correction of the major curves w ere determined as 35.3 %, the correction of the compensatory curves were determined as 39 %. There were no changes in the global kyphosis and lordosis angles. The preoperative kyphosis angles were decreased to mean 46 ° (19°-83°) from mean 63° (42°-93°) after surgery in 6 kyphoscoliosis patients. The correction rate was 26 % in these patients. The correction rate at the main curve was determined as 23 % in patients with rib anomalies, whereas it was determined as 44 % in patients without rib anomalies, that it was detected statistically significant (p<0.005). Conclusion: Less correction rates after surgery in congenital scoliosis patients who have rib anomalies at concave site of the curve is an important factor that surgeons must decide on it. En bloc resection or expansion thoracoplasty and to place vertical expansion prosthetic titanium rib - VEPTR can raise correction rates in these patients.

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