Concave Thoracoplasty (CTP) and Posterior Instrumentation for Correction of Rigid Thoracic Scoliosis: Results at 4-6 Years

INTRODUCTION: In rigid AIS, the main resistance for thoracic derotation are the anteriorly rotated ribs on the concavity. This study presents clinical and radiographic long term results of the CTP, which is a routine surgical procedure at the authors institution.

MATERIAL AND METHODS: Between 1996 and 1997 we have operated 466 scolioses. 30 patients with thoracic AIS were evaluated. Technique: The ribs on the concave side are osteotomised close to the costotransverse joint and elevated over the bended rod.

RESULTS: Mean follow up was 5.5 y. Mean preop side bending flexibility was 21%. Mean correction rate was 68%, mean rib hump correction was 3cm. Mean loss of correction 4°. There was no neurologic complication, pulmonary morbidity was not increased.

CONCLUSION: In rigid thoracic scoliosis, a release of the concave ribs by means of the CTP can both significantly increase the extent of correction and contributes to an excellent cosmetic result.