title: A biomechanical study on the effects of rib head release on thoracic spinal motion.
abstract: OBJECTIVE
  Idiopathic scoliosis is generally treated by surgical derotation of the spine. A secondary goal of surgery is minimization of the "rib hump" deformity. Previous studies have evaluated the effects of surgical releases such as diskectomy, costo-vertebral joint release, facetectomy, and costoplasty on spine mobilization and overall contribution to thoracic stability. The present study was designed to evaluate the biomechanical effects of the rib head joints alone on axial rotation, lateral bending, and segmental rotation, without diskectomy or disruption of anterior or posterior elements.
  
  
  METHODS
  Four female cadaver thoracic spines with intact sternums and rib cages were mounted in an Instron servo-hydraulic bi-axial MTS. In a 12-step sequence, the costo-vertebral and costo-transverse ligaments were released, first unilaterally from T10-T7, then bilaterally until complete disarticulation between the rib heads and the vertebral bodies. After each release, biomechanical testing, including axial rotation and lateral bending, was performed. Vertebral body displacement was also measured using electromagnetic trackers.
  
  
  RESULTS
  We found that rib displacement during axial rotation was significantly increased by unilateral rib head release, and torque was decreased with each successive cut. We also found increased vertebral displacement with sequential rib head release.
  
  
  CONCLUSIONS
  Our results show that sequential costo-vertebral joint releases result in a decrease in the force required for axial rotation and lateral bending, coupled with an increase in the displacement of vertebral bodies. These findings suggest that surgical release of the costo-transverse and costo-vertebral ligaments can facilitate segmental correction in scoliosis by decreasing the torso's natural biomechanical resistance to this correction.
authors: Showa Ika Kohgyo Company, Toyohashi, Japan.
authors: Xianfeng
authors: X
authors: Yao
authors: Thomas J
authors: TJ
authors: Blount
authors: Nobumasa
authors: N
authors: Suzuki
authors: Laura K
authors: LK
authors: Brown
authors: Christiaan J
authors: CJ
authors: van der Walt
authors: Todd
authors: T
authors: Baldini
authors: Emily M
authors: EM
authors: Lindley
authors: Vikas V
authors: VV
authors: Patel
authors: Evalina L
authors: EL
authors: Burger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D016059:Range of Motion, Articular; D012272:Ribs; D012399:Rotation; D013904:Thoracic Vertebrae