Scoliosis and fused ribs : A case report

This case report illustrates a scoliotic patient with congenital fusion of several ribs associated with a thoracic curvature. To report the procedure used to correct scoliosis in association with congenitally fused ribs. All cases of congenitally fused ribs reported in the literature are associated with malformed vertebrae. For this reason, the only proposed treatment for patients with progressive scoliosis is a spinal fusion. This report presents the first case of progressive scoliosis associated with fused ribs, but without vertebral malformation, that was managed by resection of these ribs. When worsening of the thoracic scoliosis was observed from 30 degrees at 13 months to 44 degrees at 4 years, the three fused ribs were resected en bloc. No spinal fusion was performed. The spine was held in correction by a localizer cast for 3 months. Fourteen years after treatment, the spine is almost normal; thoracic and lumbar curves are 10 degrees. When malformed fused ribs are on the concave side of a progressive scoliosis with no vertebral malformation at the same level, resection of these ribs is probably an efficient and sufficient method of treatment.