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  • Rib Hump

    Another surgery question my family and I have been discussing:

    Does your rib hump go away after the surgery? If not, does it dramatically improve? I specifically asked my doctor if he is going to touch my ribs and he says that he does not. I was kind of relieved b/c I heard that the removal of ribs is extremely painful!!
    http://mixasu.blogspot.com/

  • #2
    I was just lamenting today that I wish I had better cosmetic effects from my surgery...but that's not why I did it, so I'm okay with that! I did not have a very long fusion...the doc just worked on the worse part of me. The rib hump in my lumbar region has gone away, but I still have it a little above my fusion. I think it depends on the type of fusion, what shape you are in as far as arthritis, degeneration, etc. and I'm sure a lot of people here can answer this better than myself.

    As for the rib removal, my side incision and where my rib was removed was what bothered me most in my recovery. But PT has helped a lot with stretching and movement. The rib hump has less to do with rib removal than how much your spine has rotated...I think...anyone else out there help me with this...
    Kathy, 43
    Diagnosed as a teen
    Boston brace 2 years
    63 degree lumbar curve
    Surgery August 26, 2009
    Anterior approach fused T12-L4
    now 28 degrees

    Comment


    • #3
      Hi...

      I've seen a huge difference between patients in terms of how much reduction they get. If it's important to you, I'd recommend that you ask for some references from your surgeon, and talk to those references about their rib hump reduction.

      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


      • #4
        I didn't have any ribs removed but my rib hump has gone. There is the very slightest rise in the spot where it was, but it isn't visible and I can barely feel it. I would think Kathy's correct, it's more to do with the rotation.
        Surgery March 3, 2009 at almost 58, now 63.
        Dr. Askin, Brisbane, Australia
        T4-Pelvis, Posterior only
        Osteotomies and Laminectomies
        Was 68 degrees, now 22 and pain free

        Comment


        • #5
          My rib hump is completely gone. My surgeon said he would be able to reduce it some, so it was a big surprise when I realized it wasn't there. It was pretty large before my surgery. I did not have a thoracoplasty.

          Shell
          Chemist, 30

          1998- 18 degrees
          2003- 33 degrees
          2005- 37 degrees
          2006- 44 degrees
          May 2007- 47 degrees
          December 2007 - 50 degrees X-ray

          Surgery May 27, 2008
          Fused T1 to L2
          Curve corrected to 15 degrees X-ray

          Comment


          • #6
            My surgeon told me he would determine if a costoplasty is required during surgery. I informed him I wanted it gone and he seemed quite happy to help me with that

            I just know that if I went through this massive operation and recovery and did not get any reduction in the rib hump I would be quite

            If I were you I would really bring this up with your surgeon! You can always get a costoplasty later in life if you wish, but that means going under the blade again.
            45L/40T
            Surgery 25/1/2010
            Australia

            Knowthyself

            Scoliosis Corrected 25/1/2010 by Dr Angus Gray, Prince of Wales Private Hospital, Sydney. Fused T3-L4.

            Comment


            • #7
              My dd still has a small hump. Her scoliosis was at 60 degrees and the surgeon corrected it to the mid-20s. She was starting to rotate some as well.

              Her ribs are now even and you can tell that from the front.

              We weren't concerned about the cosmetics so much as the impact on her health if we didn't get the surgery done.

              Comment


              • #8
                My rib hump is completely gone and still have quite a bit of rotation. It shows how much the ribs alter their shape growing up with scoli.

                My rotational Ct scans are in this thread. Notice screws. Cts are looking feet to head. I'm still about 30 degrees off above and below apex after surgery.

                http://www.scoliosis.org/forum/showthread.php?t=8622

                When the Docs adjust the rotation of the vertebrae, the ribs move with that adjustment. The SSEPs determine how far they adjust.

                http://www.spine-health.com/conditio...otentials-ssep

                Overcorrection is not a good thing. Coming out pain free is the goal with scoli surgery.
                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


                • #9
                  my first opinion doc said he would not take the ribs out cuz it causes lung problems later. But if he doesnt will i still get rib hump reduction? And he didnt do any bending xrays like i thought he would only did a stretch out one were he pulled me. But i dont think that is that accurate. I hope i get some rib hump reduction, i want to look pretty if i have to be more stiff.
                  -Bethany
                  pre-op L 74*
                  pre-op Th 56*
                  surgery scheduled for jan. 6th 2010
                  getting nervous

                  Comment


                  • #10
                    You don't need rib removal to reduce the rib hump. My rib was removed in order to get to the spine and then used for my fusion. As the spine is corrected with the instrumentation, it will rotate back to close to where it should be...I believe that his is how the rib hump is reduced...correct me if I'm wrong out there!
                    Kathy, 43
                    Diagnosed as a teen
                    Boston brace 2 years
                    63 degree lumbar curve
                    Surgery August 26, 2009
                    Anterior approach fused T12-L4
                    now 28 degrees

                    Comment


                    • #11
                      Quite often, the rib hump reduces considerably during the spinal fusion operation, because the vertebra are derotated and the vertebrae get pulled back into place as this happens.

                      However, sometimes the rib hump remains to some extent, especially if it has been there for a long time and the ribs have themselves grown deformed. In this case, a procedure called a "costoplasty" (also known as a "thoracoplasty") can be done, which involves removing sections of rib at the apex of the hump in order to flatten it. This procedure can be done at the same time as a spinal fusion surgery, or it can be done later on as a separate operation.

                      Years ago the old types of rods (ie Harrington Rods, that are no longer used) did not derotate the spine, and so quite a few people with older fusions may still have a significant rib hump. In cases like this, the amount that the rib hump can be reduced is dependent on how much the spine continues to rotate out into the hump.

                      I've had a costoplasty done twice and the results are really dramatic. I had it done first during a spinal fusion surgery, but afterwards it bcame apparent that they could get a lot more correction and so I had a second costoplasty done as a standalone procedure. The results are amazing. I had a really prominent hump due to having had infantile scoliosis and a massive amount of rotation - 29 degrees on the scoliometer, which only goes up to 30 degrees! (nb degree of rotation is not the same as Cobb angle) Even though my spine still rotates into my hump, it's barely noticeable now. The surgery is very very painful, but in my opinion it is well worth it

                      Comment


                      • #12
                        That was a great explanation...cleared a few things up for me! Thanks!
                        Kathy, 43
                        Diagnosed as a teen
                        Boston brace 2 years
                        63 degree lumbar curve
                        Surgery August 26, 2009
                        Anterior approach fused T12-L4
                        now 28 degrees

                        Comment


                        • #13
                          Hi There,

                          I had a rib and some hip bone removed. My Doc. asked me if I would like it reduced and of course I said yes. If I was going to go through these surgeries, I wanted the best results I could get. As far as the rib pain, never noticed it from all the other pains.

                          I have no rib hump, don't have to hide my back anymore. But if someone bumps that rib knob or my hip when the bone was removed, it hurts like hell.

                          I find myself avoiding crowds, which is odd for me, because I was a restuaranut manager my entire a adult life.

                          Shari

                          Comment


                          • #14
                            Tonibunny

                            I agree, the Harrington rod system did about the same thing that a bumper jack would accomplish. Its not a system to brag about, that's for sure. It was the only thing they had back then, and it was used out of desperation. I believe the Luque wire came on the scene right around 1975.

                            I wonder why Dr Harrington discounted the use of screws back then. I wonder if they had flouroscopy in 1960?

                            I also had and still have a large amount of rotation, but no rib hump.If I would have continued my surgery in 1975, my rib hump correction would have been minimal. The luque wire system was a better alternative back then, at least they could grip and hold each vertebrae to a certain extent.

                            Those poor surgeons back in the old days really didn't have much to work with. I feel sorry for them, they did the best they could. I'm sure that it drove them crazy.

                            ================================================== ===============================

                            Anyone concerned about rib humps with today's hardware systems stands a much better chance of correction due to the fact that the surgeons have much better control with pedicle screws. The hardware systems they use today are engineered to the hilt. The amount of engineering time that's been used to develop this stuff is phenomenal.

                            As far as stiffness goes with fusing the thoracic area, There really isn't much difference at all since you don't bend much in that area. You do lose your ability to twist.

                            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


                            • #15
                              [QUOTE=titaniumed; I wonder if they had fluoroscopy in 1960?

                              Ed[/QUOTE]

                              Yes Ed, I can remember fluoroscopy back in the 1940's. My brother was in the hospital with corn in his lung back in 1946 and I remember seeing him behind the fluoroscope. I was only 5 at the time and when my brother wanted to see me behind the fluoroscope, I started crying and refused. There used to be fluoroscopes in shoe stores and as kids, we loved to see the bones in our feet and wiggle our toes. Eventually, they were removed from the shoe stores (the fluoroscopes, not us kids) because of the danger of radiation. I don't think the fluoroscopes of today emit as much radiation as those in the 1940's. I don't know when they were actually invented though.

                              Sally
                              Diagnosed with severe lumbar scoliosis at age 65.
                              Posterior Fusion L2-S1 on 12/4/2007. age 67
                              Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
                              Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
                              New England Baptist Hospital, Boston, MA
                              Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

                              "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

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