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Scoliosis and fused ribs. A case report
J P Damsin1, C Cazeau, H Carlioz
1Department of Children's Orthopaedic and Reconstructive Surgery, Hôpital Trousseau, Paris, France.
Study Design:
This case report illustrates a scoliotic patient with congenital fusion of several ribs associated with a thoracic curvature.
Objectives:
To report the procedure used to correct scoliosis in association with congenitally fused ribs.
Summary Of Background Data:
All cases of congenitally fused ribs reported in the literature are associated with malformed vertebrae. For this reason, the only proposed treatment for patients with progressive scoliosis is a spinal fusion. This report presents the first case of progressive scoliosis associated with fused ribs, but without vertebral malformation, that was managed by resection of these ribs.
Methods:
When worsening of the thoracic scoliosis was observed from 30 degrees at 13 months to 44 degrees at 4 years, the three fused ribs were resected en bloc. No spinal fusion was performed. The spine was held in correction by a localizer cast for 3 months.
Results:
Fourteen years after treatment, the spine is almost normal; thoracic and lumbar curves are 10 degrees.
Conclusions:
When malformed fused ribs are on the concave side of a progressive scoliosis with no vertebral malformation at the same level, resection of these ribs is probably an efficient and sufficient method of treatment.