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Silvercat
10-31-2012, 06:29 AM
Hi all

I'm aware that the ribs on the side of a thoracic curve tend to be more curved than if the spine was normal (hence the need for costoplasty or thoracoplasty) but do the ribs on the other side curve normally or do they have a more "shallow" shape (ie the opposite of the other side)?

If a fusion and costoplasty are both done (I know the ribs grow back straighter after costoplasty), do the ribs on the other side start to remodel too?

Thanks for any info!

Cheers

Lisel

LindaRacine
10-31-2012, 11:05 PM
Hi Lisel...

Typically, the upper ribs on the right side are rotated to the back. The ribs on the left side rotate toward the front. You can see the shape of the typical rib cage of a person with a thoracic or thoracolumbar scoliosis, here:

Rib Cage (http://www.rad.washington.edu/staticpix/mskbook/RibHump.gif)

Regards,
Linda

Silvercat
11-01-2012, 02:58 AM
Hi Lisel...

Typically, the upper ribs on the right side are rotated to the back. The ribs on the left side rotate toward the front. You can see the shape of the typical rib cage of a person with a thoracic or thoracolumbar scoliosis, here:

Rib Cage (http://www.rad.washington.edu/staticpix/mskbook/RibHump.gif)

Regards,
Linda

Hi Linda

thanks for your response. I wonder why the pic of the rib cage seems to show a thoracic curve to the left, when such curves are usually to the right?!

Once the spine is fused, what happens to the spinous processes? Do they start moving back to the centre? If so, how long does it take? Or are they realigned during the surgery somehow?

Cheers

Lisel

Pooka1
11-01-2012, 05:37 AM
Hi Linda

thanks for your response. I wonder why the pic of the rib cage seems to show a thoracic curve to the left, when such curves are usually to the right?!

It could be a lumbar curve which tend to go left I think or could be pictured from the bottom. But I agree it should show the most typical curve which is right Thoracic.


Once the spine is fused, what happens to the spinous processes? Do they start moving back to the centre? If so, how long does it take? Or are they realigned during the surgery somehow?

The spinous processes are usually taken as a source of bone for the fusion as far as I know. If not then they are rotated back to center along with the straightening of the spine. They will remain off-center to the extent the spine is not brought back to straight and still has rotation. Straightness and rotation are locked together somewhat in IS which always includes rotation. In fact that is why the spine curves... to accommodate the rotation from the overgrowth on the anterior vertebra.

titaniumed
11-01-2012, 07:25 PM
Hi Lisel

If you look at the CT’s in my thread, you will see the correction I ended up with. You can see the screws and how they rotated things back into shape. The ribs follow suit and so do rib humps. My rotation was much worse before my surgeries.
I did not have a thoracoplasty.

The ribs of course, are on the outside. The stuff in the middle, well, that’s just cosmic debris, Jack in the box #8 (could be #4, I forget) and gall stones.....(smiley face)

The layman’s radiology course.....

http://www.scoliosis.org/forum/showthread.php?8622-gall-stones-and-post-rotational-cat-scans&highlight=

Ed

LindaRacine
11-01-2012, 10:23 PM
Hi Linda

thanks for your response. I wonder why the pic of the rib cage seems to show a thoracic curve to the left, when such curves are usually to the right?!


Yes, thoracic curves are usually to the right, but they are sometimes to the left. Maybe the drawing is from the bottom looking up instead of from the top looking down. :)

Pooka is correct about the spinous processes usually being removed during surgery.

Confusedmom
11-01-2012, 11:01 PM
There are some videos of scoliosis surgery on You Tube. It shows how the spine is derotated during surgery.

I will say, however, that if you have a severe rotation, it may not be possible to get your ribs back to a "normal" shape without a thoracoplasty. My curve is almost gone, but my spine was so deformed for so long that my ribs are still messed up. That said, it looks a whole lot better than I did before! I have a waist in the back again and feel comfortable wearing dresses. (Now, if I would stop eating Halloween candy, maybe I could get a waist in the front again. :) )

Silvercat
11-02-2012, 12:15 AM
The spinous processes are usually taken as a source of bone for the fusion as far as I know. If not then they are rotated back to center along with the straightening of the spine. They will remain off-center to the extent the spine is not brought back to straight and still has rotation. Straightness and rotation are locked together somewhat in IS which always includes rotation. In fact that is why the spine curves... to accommodate the rotation from the overgrowth on the anterior vertebra.[/QUOTE]

Hi all

thanks for your replies!

I always thought the source of bone for fusions was from the hip or from the ribs if a costoplasty/thoracoplasty is also done.

Confusedmom - I've noticed that I have lost my waist over the last few years - I thought it was changing fat distribution due to age (I'm nearly 44), but maybe its the worsening scoli. Although my primary curve is thoracic, so not sure if the secondary lumbar curve affects my waist.

Cheers

Lisel

Pooka1
11-02-2012, 05:59 AM
I always thought the source of bone for fusions was from the hip or from the ribs if a costoplasty/thoracoplasty is also done.

Taking bone from the hip is associated with chronic pain. Bad pain that never goes away. I was ready to refuse it for my daughters but they don't do that on kids to my knowledge. It sounds like they shouldn't do it on adults either. I would change surgeons if they insisted on doing it.

Good luck.

Silvercat
11-02-2012, 06:49 AM
Hi Lisel

If you look at the CTís in my thread, you will see the correction I ended up with. You can see the screws and how they rotated things back into shape. The ribs follow suit and so do rib humps. My rotation was much worse before my surgeries.
I did not have a thoracoplasty.

The ribs of course, are on the outside. The stuff in the middle, well, thatís just cosmic debris, Jack in the box #8 (could be #4, I forget) and gall stones.....(smiley face)

The laymanís radiology course.....

http://www.scoliosis.org/forum/showthread.php?8622-gall-stones-and-post-rotational-cat-scans&highlight=

Ed

Hi Ed

wow, those scans certainly show asymmetry! (Yet you look so good from the outside.)

I can see the screws but can't really tell how they rotated things back into shape.

Lisel

titaniumed
11-02-2012, 09:31 AM
I do look good from the outside. (After 8AM, of course!)

I donít have pre surgical scans.....they would show the max rotation. Rotation was probably at around 45 degrees at the apex on both of my curves before I went in. Rotation is our biggest problem, once they rotate then the scoliosis curves take off. This doesnít happen in Kyphosis. Both have their own sets of problems.

Other than the Jack in the box, it looks pretty good. he he

I try to remain jovial about all of this stuff as you can see.
Ed