The Effect of Concomitant Rib Deformity in Congenital Scoliosis on Spinal Curve Correction after Segmental Pedicle Screw Instrumentation

Study Design Single-center, prospective study
Objective To investigate the effect of rib anomaly on surgical curve correction outcome in
congenital scoliosis
Summary of Background Data The presence of rib anomalies may complicate surgical
correction of congenital scoliosis. The outcome of surgical correction, however, has not been
documented in scoliotic patients with and without rib deformity.
Methods Percent Cobb angle decrease (CAD) after operation was calculated in 94 patients with
congenital scoliosis. Posterior segmental pedicle screw instrumentation (posterior approach) with
or without previous anterior spinal release and fusion (anterior approach) was the method of
correction. The impact of vertebral anomaly and rib deformity on CAD was examined.
Results Although the type of vertebral anomaly had no significant effect on the mean CAD, it
was significantly lower in 56 patients with rib deformity compared to that in the remaining
patients without rib deformity (35.14±15.83% vs. 51.54±17.82%; p<0.001); particularly in those
with complex, unilateral rib abnormalities; and in those with same level vertebral and rib
deformities. Patients’ sex and age at the time of operation, rib number abnormality, and the type
of operation (i.e. posterior only approach vs. anterior and posterior approach) did not contribute
significantly to Cobb angle change after operation.
Conclusions Concomitant rib deformities, particularly of complex and unilateral types,
significantly compromise operative curve correction outcome in congenital scoliosis