title: Scoliosis after chest wall resection.
abstract: BACKGROUND
  There has been an increased focus on the role of rib abnormalities in the development of scoliosis. Rib resection may influence the development of scoliosis. Although scoliosis has been identified in patients after thoracotomy, most of the currently available information is from case reports.
  
  
  METHODS
  We examined records of 37 patients who underwent a chest wall or rib resection for rib lesions at our institution during the period of 1992 to 2005. Adequate data was available in 21 patients. We gathered data on demographic information, location of resection, and changes in curvature after resection based on radiograph or scout CT films at the latest follow-up appointment.
  
  
  RESULTS
  Fourteen of 21 patients developed scoliosis with a mean Cobb angle of 25.8° (10°-70°). Eleven of these 14 patients had a progressive spinal deformity after chest wall resection with an average change in curvature of 29° (10°-70°). Eight of those 11 developed a convex toward the resection, while 3/11 developed a convex away from the resection. Seven of the eight patients with resections that included a rib superior to the sixth rib developed scoliosis, while four of 13 with resections below the sixth rib developed scoliosis.
  
  
  CONCLUSIONS
  Patients who have had a rib or chest wall resection are at risk for developing scoliosis, particularly if the resection is performed above the sixth rib.
authors.affiliation: Department of Orthopaedic Surgery, Instructor, Harvard Medical School, Children's Hospital Boston, 300 Longwood Avenue, Hunnewell 2, Boston, MA 02115 USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Glotzbecker
authors.affiliation: Department of Orthopaedic Surgery, Instructor, Harvard Medical School, Children's Hospital Boston, 300 Longwood Avenue, Hunnewell 2, Boston, MA 02115 USA.
authors.forename: Meryl
authors.initials: M
authors.lastname: Gold
authors.affiliation: Department of Surgery, Children's Hospital Boston, Boston, MA 02115 USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Puder
authors.affiliation: Department of Orthopaedic Surgery, Instructor, Harvard Medical School, Children's Hospital Boston, 300 Longwood Avenue, Hunnewell 2, Boston, MA 02115 USA.
authors.forename: M Timothy
authors.initials: MT
authors.lastname: Hresko
keywords: Chest wall lesion; Chest wall resection; Rib fusion; Rib resection; Thoracogenic scoliosis