The rib construct for management of early onset kyphotic deformity

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Presentation transcript:

The rib construct for management of early onset kyphotic deformity

Initial patient note sternum “pulled out” of stomach Result 7 yrs later prominent rib hooks replaced with screws convex side at definitive fusion 12 yo with VATER syndrome Rib construct

Biomechanical testing Porcine spines, 21.3 +/-1.3 kg, 6 in each group. Loaded from 0-90°. All 6 pedicle screw constructs failed 35.8 +/- 1.3 °. No rib construct failed.

Clinical Results 14 patients early onset kyphosis 4 syndromic 4 congenital 3 idiopathic 2 neuromuscular 1 juvenile osteoporosis Followup 24-78 mos (49) Age initial surgery 26-125 months (84) Congental kyphosis 3 patients with T1-5 kyphosis > 20°, preop T1-5 24°,total kyphosis 42; postop T1-5, 17.3°, total kyphosis 37° 11 patients with T1-12 kyphosis >70°, average preop 104°, postop 66° Neurofibromatosis- preop 134°, postop 55° NO PJK!!