Discordance in spinal and thoracic correction using powerful full screw constructs in idiopathic scoliotic

The pre and postoperative rib-vertebra angles and Cobb angles in patients with idiopathic scoliosis pre and post operatively treated with full transpedicular screw constructs were compared. Eighteen patients had right thoracic curves while only two had a left curve. 7 curves were Lenke's type 3C, 6 type 5C, 4 type 1A, 3 type 6C and one type 2A. Convex side showed larger RVAs compared to the concaved side. The rib vertebra angle decreased from T1 to T12. The rib vertebra angles pre operatively (left vs right) were significantly different in every single level apart from T1, T7, T8 and T9. Cobb angle significantly improved post - operatively (p=0.0001). The post-operative rib vertebra angle differences significantly differed at all levels (p>0.05), but not in the region spanning the thoracic apex (T6-T7-T8). The powerful full-screw instrumentation corrects the Cobb angle very satisfactorily, but only partially corrects the rib cage asymmetry as this is expressed by the rib vertebra angle differences pre and post operatively. The small or no effect on the stiff apical ribs (T6-T8) and the possible role of the related musculature need to be further evaluated and analyzed.