Abstract
Background data
There has been an increased focus on the role of rib abnormalities in the development of scoliosis. Rib resection may influence the development of scoliosis. Although scoliosis has been identified in patients after thoracotomy, most of the currently available information is from case reports.
Methods
We examined records of 37 patients who underwent a chest wall or rib resection for rib lesions at our institution during the period of 1992 to 2005. Adequate data was available in 21 patients. We gathered data on demographic information, location of resection, and changes in curvature after resection based on radiograph or scout CT films at the latest follow-up appointment.
Results
Fourteen of 21 patients developed scoliosis with a mean Cobb angle of 25.8° (10°–70°). Eleven of these 14 patients had a progressive spinal deformity after chest wall resection with an average change in curvature of 29° (10°–70°). Eight of those 11 developed a convex toward the resection, while 3/11 developed a convex away from the resection. Seven of the eight patients with resections that included a rib superior to the sixth rib developed scoliosis, while four of 13 with resections below the sixth rib developed scoliosis.
Conclusion
Patients who have had a rib or chest wall resection are at risk for developing scoliosis, particularly if the resection is performed above the sixth rib.
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References
Kim S, Lee S, Arsenault DA et al (2008) Pediatric rib lesions: a 13 year experience. J Pediatr Surg 43:1781–1785
Kozlowski K, Campbell J, Morris L et al (1989) Primary rib tumours in children (report of 27 cases with short literature review). Australas Radiol 33:210–222
Larsson SE, Lorentzon R (1974) The incidence of malignant primary bone tumours in relation to age, sex and site. A study of osteogenic sarcoma, chondrosarcoma and Ewing’s sarcoma diagnosed in Sweden from 1958 to 1968. J Bone Joint Surg Br 56B:534–540
Shamberger RC, Tarbell NJ, Perez-Atayde AR et al (1994) Malignant small round cell tumor (Ewing’s-PNET) of the chest wall in children. J Pediatr Surg 29:179–184 (discussion 84–5)
Kawakami N, Winter RB, Lonstein JE et al (1994) Scoliosis secondary to rib resection. J Spinal Disord 7:522–527
Langenskiold, Michelsson JE (1961) Experimental progressive scoliosis in the rabbit. J Bone Joint Surg Br 43:116–120
Langenskiold A, Michelsson JE (1962) The pathogenesis of experimental progressive scoliosis. Acta Orthop Scand Suppl 59:1–26
Pal GP (1991) Mechanism of production of scoliosis. A hypothesis. Spine 16:288–292
Thomas S, Dave PK (1985) Experimental scoliosis in monkeys. Acta Orthop Scand 56:43–46
Sevastik J, Agadir M, Sevastik B (1990) Effects of rib elongation on the spine. I. distortion of the vertebral alignment in the rabbit. Spine 15:822–825
Sevastik J, Agadir M, Sevastik B (1990) Effects of rib elongation on the spine. II. correction of scoliosis in the rabbit. Spine 15:826–829
Deguchi M, Kawakami N, Kanemura T et al (1995) Experimental scoliosis induced by rib resection in chickens. J Spinal Disord 8:179–185
DeRosa GP (1985) Progressive scoliosis following chest wall resection in children. Spine 10:618–622
Ohara K, Nakamura K, Ohta E (1997) Chest wall deformities and thoracic scoliosis after costal cartilage graft harvesting. Plast Reconstr Surg 99:1030–1036
Soyer T, Karnak I, Ciftci AO et al (2006) The results of surgical treatment of chest wall tumors in childhood. Pediatr Surg Int 22:135–139
Wong-Chung J, France J, Gillespie R (1992) Scoliosis caused by rib fusion after thoracotomy for esophageal atresia. Report of a case and review of the literature. Spine 17:851–854
Tsirikos AI, McMaster MJ (2005) Congenital anomalies of the ribs and chest wall associated with congenital deformities of the spine. J Bone Joint Surg Am 87:2523–2536
Dunlay RP, Jones KB, Weinstein SL (2007) Scoliosis caused by rib fusion following thoracotomy for tracheoesophageal fistula: case report. Iowa Orthop J 27:95–98
Gilsanz V, Boechat IM, Birnberg FA et al (1983) Scoliosis after thoracotomy for esophageal atresia. AJR Am J Roentgenol 141:457–460
Mehta HP, Snyder BD, Baldassarri SR et al (2010) Expansion thoracoplasty improves respiratory function in a rabbit model of postnatal pulmonary hypoplasia: a pilot study. Spine 35:153–161
Campbell RM Jr, Smith MD, Mayes TC et al (2003) The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am 85:399–408
Campbell RM Jr, Smith MD, Mayes TC et al (2004) The effect of opening wedge thoracostomy on thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am 86:1659–1674
Michelsson JE (1965) The development of spinal deformity in experimental scoliosis. Acta Orthop Scand Suppl 81:1–91
Deguchi M, Kawakami N, Kanemura T (1996) Correction of scoliosis by rib resection in pinealectomized chickens. J Spinal Disord 9:207–213
Machida M, Dubousset J, Imamura Y et al (1993) An experimental study in chickens for the pathogenesis of idiopathic scoliosis. Spine 18:1609–1615
Robin GC, Stein H (1975) Experimental scoliosis in primates. Failure of a technique. J Bone Joint Surg Br 57:142–145
Piggott H (1971) Posterior rib resection in scoliosis. A preliminary report. J Bone Joint Surg Br 53:663–671
Barnes J (1979) Rib resection in infantile idiopathic scoliosis. J Bone Joint Surg Br 61:31–35
Sistonen SJ, Helenius I, Peltonen J et al (2009) Natural history of spinal anomalies and scoliosis associated with esophageal atresia. Pediatrics 124:e1198–e1204
Dwork RE, Dinken H, Hurst A (1951) Post thoracoplasty scoliosis. Arch Phys Med Rehabil 32:722–729
Loynes RD (1972) Scoliosis after thoracoplasty. J Bone Joint Surg Br 54:484–498
Stauffer ES, Mankin HJ (1966) Scoliosis after thoracoplasty. A study of thirty patients. J Bone Joint Surg Am 48:339–348
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Glotzbecker, M.P., Gold, M., Puder, M. et al. Scoliosis after chest wall resection. J Child Orthop 7, 301–307 (2013). https://doi.org/10.1007/s11832-013-0519-2
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DOI: https://doi.org/10.1007/s11832-013-0519-2