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  • Shape of rib cage

    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

  • #2
    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

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

    Comment


    • #3
      Originally posted by LindaRacine View Post
      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

      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

      Comment


      • #4
        Originally posted by Silvercat View Post
        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.
        Last edited by Pooka1; 11-01-2012, 07:32 PM.
        Sharon, mother of identical twin girls with scoliosis

        No island of sanity.

        Question: What do you call alternative medicine that works?
        Answer: Medicine


        "We are all African."

        Comment


        • #5
          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/showt...ans&highlight=

          Ed
          49 yr old male, now 63, the new 64...
          Pre surgery curves T70,L70
          ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
          Dr Brett Menmuir St Marys Hospital Reno,Nevada

          Bending and twisting pics after full fusion
          http://www.scoliosis.org/forum/showt...on.&highlight=

          My x-rays
          http://www.scoliosis.org/forum/attac...2&d=1228779214

          http://www.scoliosis.org/forum/attac...3&d=1228779258

          Comment


          • #6
            Originally posted by Silvercat View Post
            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.
            Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
            ---------------------------------------------------------------------------------------------------------------------------------------------------
            Surgery 2/10/93 A/P fusion T4-L3
            Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

            Comment


            • #7
              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. )
              age 48
              80* thoracolumbar; 40* thoracic
              Reduced to ~16* thoracolumbar; ~0* thoracic
              Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
              Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
              Not "confused" anymore, but don't know how to change my username.

              Comment


              • #8
                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

                Comment


                • #9
                  Originally posted by Silvercat View Post
                  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.
                  Sharon, mother of identical twin girls with scoliosis

                  No island of sanity.

                  Question: What do you call alternative medicine that works?
                  Answer: Medicine


                  "We are all African."

                  Comment


                  • #10
                    Originally posted by titaniumed View Post
                    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/showt...ans&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

                    Comment


                    • #11
                      I do look good from the outside. (After 8AM, of course!)

                      I don’t 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 doesn’t 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
                      49 yr old male, now 63, the new 64...
                      Pre surgery curves T70,L70
                      ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
                      Dr Brett Menmuir St Marys Hospital Reno,Nevada

                      Bending and twisting pics after full fusion
                      http://www.scoliosis.org/forum/showt...on.&highlight=

                      My x-rays
                      http://www.scoliosis.org/forum/attac...2&d=1228779214

                      http://www.scoliosis.org/forum/attac...3&d=1228779258

                      Comment

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