Are there indications for partial rib resection in patients with adolescent idiopathic scoliosis treated with cotrel-dubousset instrumentation ?

In adolescent idiopathic scoliosis the cosmetically uiiacceptable rib pfominence It one of the main reasons patients seek treatment. Ninety-night patients were reviewed with Cotrel-Dubousset (CD) instrumentation (average follow-up, 21 months; average prooperative curve, 53°) and 27 patients with Harrington Instrumentation and rib resection (average follow-up, 43 months; average preoparative curve, 52°). Of the 98 patients who hod CD instrumentation, 15 uncerwant concomitant rib resection. Of the 83 patients without rib resection, 71 (72%) were rated satisfactory and 12 unsatisfactory by cosmetic criteria based on residual rib deformity. These results were compared to those of 21 patients receiving Harrington rod instrumentation and nb resection, of whom 23 (95% fibers rated S3 satisfactory. AH 15 patients with CD and rib resection were rated satisfactory. The CD patients were than redivided into two groups (Ha rasoetion indicated or rib resection not Indicated) bs follows: the 12 unsatisfactory CD patients without rib resection (in whom a rib rgscction should nave bean dano) were grouped with the 15 CD patients who underwent rib resection, for a total of 21 rib resections indicated, or 26%. This grojp was comparer! to the 71 satisfactory CD patients without rib ruuoction (rib resection not indicated!. Patients with a rib prominsnce of > l5a preopotatively heel grshould havo had a rib reseclion, Patients with b higher chance of needing rib resection included those with a ourve severity greater than 60% curva Flexibility less than 20%, a preoperative rib prominence > 10", or inlrapjjorative curve correction of less than 50%.