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Thread: Correction for Crankshafting - Rib Hump? - Thoracoplasty

  1. #1
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    Correction for Crankshafting - Rib Hump? - Thoracoplasty

    This is a question for all of those who have already been through a thoracoplasty or have been a canidate for the surgery for correction to a rib hump (which in my case is caused by crankshafting). Please help ...

    Just for a bit of background:

    In 1999, I had posterior total spine fusion (ranging from the bottom of my neck all the way down) to correct for a 3-curve scoliosis (Lower, Middle, Upper Back ~ *40,*90,*30). Now, according to every doctor I have seen has indicated, my spinal surgery is considered a major success with complete fusion - and my main residual curve ending at 45 degrees.

    Yet ... within a few months my upper back started to rotate. I did everything the doctors told me to a tee: the usual - do not carry anything above 10 pounds for the following year, no contact activity for two years, etc. After 5 years post-op, my rotation has progressively worsen. Now a full 9 years post-op, my rotation seemingly has stopped worsening. BUT the rib-hump is very noticeable at around 5 cms - even through sweaters - which is the usual cure-all cosmetic fix for this deformity.

    Okay ... so here come the questions: If you have had thoracoplasty, as a whole do you feel it was worth it? Did it completely flatten out the rib hump, reduce it or not correct it at all? Are there any limitations in movement associated with the surgery? Do you ever experience difficulty breathing? Has your lung capacity diminished over the years or is it not noticable? Are there any restrictions on physical activity? And lastly, if you could go back in time, would you do it all again?

    Thanks for all the help! Cheers!

  2. #2
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    Quote Originally Posted by Lorrie24 View Post
    Okay ... so here come the questions: If you have had thoracoplasty, as a whole do you feel it was worth it? Did it completely flatten out the rib hump, reduce it or not correct it at all? Are there any limitations in movement associated with the surgery? Do you ever experience difficulty breathing? Has your lung capacity diminished over the years or is it not noticable? Are there any restrictions on physical activity? And lastly, if you could go back in time, would you do it all again?

    Thanks for all the help! Cheers!
    Nice to meet you Lorrie24,

    Well I have had a thoracoplasty! I will try to answer your questions with the best of what I know from my experience.

    I do feel it was worth it. Mine was done in 1999 and I had 7 ribs done. It isn't completely flattened but diminished quite a bit. It doesn't correct anything as far as rotation just help to flatten the area of the rib hump. I really only experienced difficulty breathing afterwards and took a bit to gain strength but it is real important to do the breathing exercises. My current lung capacity hasn't reduced at all. In fact it has probably improved as the years have gone by.

    You asked if there was any restrictions on physical activity. Well I had mine done with my second fusion. So I had a lot going on. My rib hump is on the right side. I am also right handed. After the surgery I lost almost full use, and strength of my right hand. I could feel completely fine but movement was gone. I had to have therapy twice afterwards to restrengthen and help the movement in that arm. I did for some years following have pain in that arm and shoulder. Now it has been 10 years and I have little or no problems. The only thing is full range of motion never full restored but most of it. I can now say I am glad I did it. There shortly afterwards I wasn't so positive. I didn't know what to expect and it was a surprise for me.

    I am not sure if you had numbness in your back after your fusion for sometime but I did. It takes time for things to regenerate back to what could be called normal. I can now look back and say it was good for cosmetic reasons. People don't know that I have Scoliosis, just me!

    If you have any questions or want to talk, just send me a message. My thoughts will be with you.
    Adrienne
    1991 T4 - T12 Fusion
    1993 Rod Removal
    1999 T4-L4 Fusion (7 rib thoracoplasty)
    2002 Rod Removal 58;49 degrees
    Denver, CO; Dr. John Odom
    Rocky Mtn. Spine Center

  3. #3
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    Nov 2008
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    Unhappy

    Hi!
    This is my first time posting an entry, but I thought I would comment on your question about thoracoplasty. I had one in 1995 when I had my T4 - L2 correction. I had a 90 degree right curve. The rib hump was quite big to begin with and although it wasn't completely gone, I was happy with the results.

    Now I am facing a surgery on L2 and below . My rib hump now seems as if it has increased, but that could be because the area under my upper rods is disintegrating and may just seems worse.

    I would do it again, I just wish they had been able to correct my upper and lower area all at once, but at that time they said it would be too much correction for my body. Things have changed since.

    I dont know if that helped you. I don't have limited lung capacity, but I never did.

    Blessings

  4. #4
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    I had my thorocoplasty about 12 years ago. My fusion was done back in 1963 so you can see the two procedure were very separate. The surgery was a laproscopic procedure and I had parts of four ribs removed. The lung had to be collapsed for the surgery so I was hospitalized with a chest tube until the xray showed full lung reexpansion. You can get into some repiratory trouble if you don't take big breaths after the surgery. Do your incentive spirometry even though it hurts. I didn't and they slapped oxygen on me when my oxygen saturations went down. I should have known better as I am a Respiratory Therapist. The pain associated with any kind of thorocotomy can be significant. This is the only surgery that I asked for the pain meds before they were due. I went home on percocet, changed to Ultram, and finally weaned myself off gradually. I began to have sympathy for people who are in chronic pain. I had no restrictions after the surgery and no kind of brace or binding. I work out with a trainer and my upper body seems to be weaker on the surgery side, even after all this time. It's not significant but I can tell when I'm doing overhead weights. As far as results, I'm not sure. I thought it was better after the surgery but now I would have to see before and after pictures to be convinced. The physician that did the surgery was not "in network" so he had to get authorization to do the procedure at an "in network" hospital. I ended up with a central line and overnight in the ICU. The physician said that if the surgery had been done at his hospital, it would not have been such a big deal as they would have been more familiar and comfortable with the procedure. Would I do it over again? I don't know. I'm older now so I think the recovery would be a little more difficult. I would have to be guaranteed more significant results to consider it. Maybe I would because I hate this rib hump.

  5. #5
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    Thanks ...

    Thank you everyone for replying! All your responses really helped. I am quite sure I am going to undergo the isolated thorocoplasty in the next couple of months. So crossing my fingers.

    I do have some last questions ... Was anyone guarenteed results with the thorocoplasty?

    Also, did any of you have the rib hump as a result of the fusion or the result of the scoliosis (pre-fusion) or both?

    And ... do you know the methods used on your thorocoplasty? (I have heard something like wire being tied to the ribs and around the rods ... or the implanting titanium ribs ... or using bone grafting to reconnect the rib - and essentially 'regrow' them.)

    THANKS FOR EVERYTHING!!!

  6. #6
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    Lorrie24,

    I got my rib hump after my first fusion. That is what lead to a second fusion surgery and the thoracoplasty.

    When they did mine they took 7 partial ribs and left it! That's it. The Dr. told me that the ribs would go down and then scar tissue would grow there and be just as strong as ribs.
    Adrienne
    1991 T4 - T12 Fusion
    1993 Rod Removal
    1999 T4-L4 Fusion (7 rib thoracoplasty)
    2002 Rod Removal 58;49 degrees
    Denver, CO; Dr. John Odom
    Rocky Mtn. Spine Center

  7. #7
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    Nov 2005
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    Hi Lorrie,

    The standard way of performing a thoracoplasty is to cut sections out of the ribs at the apex of the hump in order to shorten them. Each rib has a "sleeve" of muscle around it, so these are shortened too. The cut ends of the shortened sleeves are then sewn back together, and as the ribs heal they follow the muscles and the ends of the bones reattach and heal back together again in their shortened position.

    Hope that helps!

    Toni xx

  8. #8
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    Jun 2008
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    Questions

    Hi everyone and Augemac,


    I was reading about thoracoplasty...I guess I'm wondering if it would possibly help my pain....I am having so much pain in my right shoulder blade region. The pain has been there constantly in that spot since my scoliosis first developed (over 10 years ago now). Would having a thoracoplasty possibly help pain in that area or is it more for cosmetic reasons. I don't have a big rib hump...just tons of pain. I underwent rod removal two months ago but the pain there is worse than ever. I would appreciate any thoughts.

    Augemac: you mentioned pain in your shoulder and arm? Where in your shoulder and arm did you have pain and what did it feel like??

    Scolimich

  9. #9
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    Quote Originally Posted by scolimich View Post
    Would having a thoracoplasty possibly help pain in that area or is it more for cosmetic reasons.

    Augemac: you mentioned pain in your shoulder and arm? Where in your shoulder and arm did you have pain and what did it feel like??
    Scolimich,

    Well I am not a Dr but I believe that it is more of a cosmetic reason. Although, with a less of a hump then when you sit you aren't so lopsided. I had pain right in my arm socket and down my arm. It felt like cold, ache, dead feeling like I couldn't or want to move it. Nerve damage or pinched!! Not numbness but not good feeling. Now it is okay. Just usual pain associated with back and arthritis.
    Adrienne
    1991 T4 - T12 Fusion
    1993 Rod Removal
    1999 T4-L4 Fusion (7 rib thoracoplasty)
    2002 Rod Removal 58;49 degrees
    Denver, CO; Dr. John Odom
    Rocky Mtn. Spine Center

  10. #10
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    Currently living in Chicago, raised in Burlington, VT, and had both surgery's by Dr. Arronson at Fletcher Allen
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    Quote Originally Posted by scolimich View Post
    Hi everyone and Augemac,


    I was reading about thoracoplasty...I guess I'm wondering if it would possibly help my pain....I am having so much pain in my right shoulder blade region. The pain has been there constantly in that spot since my scoliosis first developed (over 10 years ago now). Would having a thoracoplasty possibly help pain in that area or is it more for cosmetic reasons. I don't have a big rib hump...just tons of pain. I underwent rod removal two months ago but the pain there is worse than ever. I would appreciate any thoughts.
    Sounds like we are in a similar situation. I also have pain along my right shoulder blade, with occasional muscle spasms, and had my rods removed. My surgeon suggested thoracoplasty several years ago, and I decided against it at the time. I didn't feel the need to undergo more surgery to correct something cosmetic.Guess I wasn't your average 19 year old in that sense. I've been thinking more about it recently, and wondering if I should have gone through with it while I was still covered by my parents insurance. I would also love to hear from people who have had it, and if you've noticed any non-cosmetic improvements. How does it feel to sit in a hard-backed chair with BOTH sides of your back touching AND facing straight forward?
    Fused T2-L3 in March, 2000
    Hardware removed April 2003
    Living a full, active life almost 9 years later.
    Decided against thoracoplasty and revision to correct crankshafting and cervical kyphosis because right now a few more curves don't bother me enough to warrant more surgery.

  11. #11
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    Even though it took time to heal from it I would do it again. Because yes when you do sit in a hard chair it is nice to be able to do so.
    Adrienne
    1991 T4 - T12 Fusion
    1993 Rod Removal
    1999 T4-L4 Fusion (7 rib thoracoplasty)
    2002 Rod Removal 58;49 degrees
    Denver, CO; Dr. John Odom
    Rocky Mtn. Spine Center

  12. #12
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    Feb 2009
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    thoracoplasty

    This was my favorite surgery of my three! now no one outwardly knows of my scoliosis and I can sit in a chair and dress without bothering about thinking about my back. I lost a lot of lung capacity for about 2 years but am now very active again (a runner) and with much less pain. Good luck!

  13. #13
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    Jun 2008
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    Randi K

    Randi K,

    How come your surgeon suggested thoracoplasty?? I'm just curious because I wonder if that would help to get rid of my shoulder blade pain. If I can ask...why did you have your rods removed?? I had mine removed because I was having so much pain....especially in the right shoulder blade region. However, that pain has been there since my scoliosis happened over 10 years ago. When did your pain in the shoulder blade begin????

    Putting the rods in never helped that blade pain to go away as they thought it would. I had the rods out because in the last 3 years, i began having so much more pain on top of that shoulder blade issue. Could you share your story with me?

    Also, you asked about sitting in a hard chair looking straight forward.....! I am miserable. There are only certain chairs I can even stand to sit in without wanting to just cry....it's THAT painful in the right shoulder blade area.

  14. #14
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    Randi K,

    Well one of my first suggestions would be to go see a massage therapist that specializes in myofascial release. They can help to get under the shoulder blade and release some of that stress. After doing that a few times you will feel better!! Then go see a surgeon regarding the thoracoplasty! It takes time to heal but worth what it gives!!

    I still have regular massages and STRETCH!!

    Take care and good luck!!
    Adrienne
    1991 T4 - T12 Fusion
    1993 Rod Removal
    1999 T4-L4 Fusion (7 rib thoracoplasty)
    2002 Rod Removal 58;49 degrees
    Denver, CO; Dr. John Odom
    Rocky Mtn. Spine Center

  15. #15
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    Jul 2011
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    1
    Hello everyone,


    I had my back fused from T-11 to L4 back in 2008 with the intention of my thoracic curve straightening itself. Everything has gone down hill since the surgery and about three weeks ago my spine decided to rotate more overnight, leaving me with a more prominent rib hump on my right upper to mid back, protruding ribs in my front left side, and a greater loss of stability as well as a severe increase in pain. My intention now is to find a non-surgical way to de-rotate the spine to how is was a few weeks ago, which is...ambitious to say the least. My question to anyone who has had this procedure done is if the surgery is just done to alter the prominence in the back or if the surgeons take care of the front deformity as well.

    Best

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