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Thread: thoracoplasty

  1. #1
    Join Date
    Apr 2006
    Posts
    109

    thoracoplasty

    My surgeon told me he does not reccomend this. He told me he has seen it go wrong and cause substantial pain for the patient. He said that so long as he is able to de-rotate the spine enough, that should reduce the rib hump quite a bit. The rub hump is what bothers me most (cosmetically) about the scoliosis. Has anyone had a rib hump reduction? What were your experiences like? Thanks!
    28 years old. Dx at age 14.

    1994 20T/20L
    1998 22T/20L
    2002 30T/28L
    2006 34T/28L
    2008 43T/34L

    considering surgery in the near future as the curvature is getting progressively worse and for pain management.

    XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

  2. #2
    Join Date
    Jan 2006
    Location
    near Philadelphia
    Posts
    1,260
    A thorocoplasty IS very painful, but I have to say I got an excellent cosmetic result with it.
    Chris
    A/P fusion on June 19, 2007 at age 52; T10-L5
    Pre-op thoracolumbar curve: 70 degrees
    Post-op curve: 12 degrees
    Dr. Boachie-adjei, HSS, New York

  3. #3
    Join Date
    Oct 2005
    Location
    Chicago north suburb
    Posts
    772
    Chris,

    Why would you have required a thorocoplasty? I thought this is a procedure used to reduce the rib hump caused by a large thoracic curve.

    Chris

  4. #4
    Join Date
    Nov 2003
    Location
    PA
    Posts
    360
    I really wanted to get a thoracoplasty until my doctor said he didn't recommend it, especially since I have asthma. He said it could cause more long term breathing problems in my case.
    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

  5. #5
    Join Date
    Jan 2006
    Location
    near Philadelphia
    Posts
    1,260
    Chris -- I had a large rib hump that was visible when I bent over and a huge degree of rotation. Also, Boachie likes to use rib material for the fusion itself.

    Brirarose, regarding breathing issues: I was told it would take up to two years for full pulmonary function to return, but I am just starting to have dramatic improvement with that after doing a LOT of breathing exercises.
    Chris
    A/P fusion on June 19, 2007 at age 52; T10-L5
    Pre-op thoracolumbar curve: 70 degrees
    Post-op curve: 12 degrees
    Dr. Boachie-adjei, HSS, New York

  6. #6
    Join Date
    Jan 2008
    Posts
    111
    Dear Mobee,

    I had a 6-7 rib thoracoplasty in 1983 followed by a further 3 rib thoracoplasty in 1987 for severe scoliosis of probably over 100 degrees that resulted in a large right thoracic hump by the age of 16. While sharing my experiences, I would like to say that I am no medical expert, have limited knowledge, but can share my opinions and suggestions based on subjective experience, and the limited material that I've read. There are many major differences in our situations. While looking at your curve pattern in your signature, I see that in your teens your curve was quite mild and probably would not have resulted in a severe deformity at that time. Granted, it may not have seem mild to you, but in my mind, comparitively speaking, it was.
    Your curve appears to have progressed gradually after full growth. I would think that your ribs are more displaced by the spinal curve rather that becoming deformed during the growth spurt period of adolescence. I have seen before and after pictures of several people who have had corrections without thoracoplasty on various surgeon's websites together with patient's testimonials. Many of these patient's state and their pictures show that the rib hump was significantly eliminated. Your surgeon is probably right that in correction your curve, the ribs may assume a more normal pattern. I think that with this medical condition that we have, surgery won't make us perfect but can normalize the spine and appearance as much as possible.
    I had significant improvement in my rib hump after thoracoplasty, but still have significant deformity. I still have a severe curve of 90 degrees after correction. My thoracic curve is under my right shoulder blade causing it to stick out significantly. After menopause, (I'm 63) I developed breathing problems and my pulmonologist states that the thoracoplasty probably contributed to that. I also had to wear a molded fiberglass brace for 6 months after that surgery which I could not remove to protect my lungs etc. As far as pain goes, I had 14 vertebrae fused at the age of 16 and remember having severe pain at that time. That was when pain control measure are not like what they are today. With the thoracoplasty, I had a lot of pain but not as severe. However, I remember having pain for a longer period of time and when I moved my arms. I also had some numbness which eventually went away. Scoliosis surgeons have learned a lot over the years, and I would recommend seeking out the best scoliosis surgeon you can find and following his advice.
    Good luck to you, Mobee, and I wish you the best as you make your decisions.

  7. #7
    Join Date
    Apr 2006
    Posts
    109
    Thanks everyone. I think my rib hump looks awful, but, by surgical standards my curve is on the lower end of the scale (41 degrees). Maybe just be derotating the spine they can provide a decent correction. Thanks again, you are all great! Wishing-how great was your curve before surgery?
    28 years old. Dx at age 14.

    1994 20T/20L
    1998 22T/20L
    2002 30T/28L
    2006 34T/28L
    2008 43T/34L

    considering surgery in the near future as the curvature is getting progressively worse and for pain management.

    XRAYS and pics at 28 years old. http://www.freewebs.com/skiergirl24/apps/photos/

  8. #8
    Join Date
    Jan 2008
    Posts
    111
    Dear Mobee,

    Believe it or not, I do not know my actual degree of curvature before my surgery at age 16. I was very naive in those days. It was also in 1962 and no instrumentation, rods etc. were used. I had a plaster cast for a year which crumbled, and I lost a lot of the beautiful correction that was originally obtained. Since then, there are more advanced rods, techniques, surgical equipment etc. Also, in 1983 when I had the 7 rib thoracoplasty, the surgeon attempted a revision of the previous fusion and had to abandon it due to risk.He had difficulty breaking down the old fusion, and refused the vertebra that he worked on. That also is probably why I had the fiberglass cast also to hold the fusion until it healed as there were no rods. I am scheduled to have a revision this June. Many advances have been made in scoliosis surgery since then which I just discovered a year ago.
    Take care and the best to you.

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