The role of concave rib osteotomies was studied in a series of 25 patients with right thoracic idiopathic scoliosis who underwent Harrington distraction instrumentation and segmental sublaminar wiring of the thoracic curve. Group I had ten patients with rigid curves who had instrumentation, fusion, and segmental concave rib osteotomies. Group II had 15 patients with flexible curves who underwent instrumentation and fusion alone. Preoperative side bending curve reduction averaged 23percnt; in Group I and 49percnt; in Group II. Postoperative correction was similar in both groups with Group I achieving 60percnt; (plusmn;10percnt;) overall correction and Group II, 57percnt; (plusmn;8percnt;). Group I underwent 56percnt; further reduction from side bending compared with Group II's 12percnt; reduction. It was concluded that if preoperative side bending correction was below 35percnt; of standing curve, curve correction comparable to flexible cases could be achieved through multiple concave rib osteotomies. Neurologic risk was not increased, but there was increased pulmonary morbidity of 30percnt;.
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