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Rib Deformities in Congenital Scoliosis

Xue, Xuhong MD; Shen, Jianxiong MD; Zhang, Jianguo MD; Zhao, Hong MD; Li, Shugang MD; Zhao, Yu MD; Liang, Jinqian MD; Qiu, Guixing MD; Weng, Xisheng MD

doi: 10.1097/BRS.0000000000000008

Study Design. Retrospective review.

Objective. To identify the incidence and characteristics of rib anomalies in patients with congenital scoliosis (CS) in a Chinese population.

Summary of Background Data. Rib deformities and intraspinal anomalies often coexist in individuals with CS. Rib deformities may assist in diagnosing occult anomalies in these patients. The incidence of rib anomalies and the relationship between rib and vertebral abnormalities in Chinese patients with CS have not been reported.

Methods. A total of 382 patients operated on at Peking Union Medical College Hospital during January 2010 to October 2012 were identified from a single institutional database. The demographic distribution, clinical and radiographical data were collected to investigate the incidence of rib anomalies, and the vertebral and intraspinal abnormalities associated with it.

Results. A total of 192 patients (50.3%) were documented with rib anomalies including numerical variation (46.4%) and structural changes (72.4%). Missing ribs was the most commonly seen anomaly in these patients, accounting for 43.8% of the rib anomalies. Of the patients with rib anomalies, a slightly higher proportion of patients had simple anomalies, 106 (55.2%) versus 86 (44.8%). Rib changes were most common in patients with thoracic or thoracolumbar vertebral anomalies, and occurred most frequently on the concave side (65.5%) or in the lower thoracic spine (36.5%). The overall incidence rate of intraspinal anomalies was 40.1% (153/382), and these were most commonly seen in patients with thoracic vertebral anomalies or with upper and middle thoracic rib anomalies.

Conclusion. The incidence of rib anomalies was 50.3% in surgical patients with CS. The rib anomalies vary with the location and type of vertebral anomalies. The incidence of intraspinal anomalies was significantly higher in patients with rib anomalies than in those without rib anomalies.

Level of Evidence: 4

The incidence of rib abnormalities in surgical patients with congenital scoliosis was investigated. Rib anomalies occurred most frequently on the concave side of scoliosis and in lower thoracic region. The associations among rib, vertebral, and intraspinal anomalies were evaluated to provide advice for clinicians.

From the Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, China.

Address correspondence and reprint requests to Jianxiong Shen, MD, Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No. 1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing 100730; E-mail:

The manuscript submitted does not contain information about medical device(s)/drug(s).

National Natural Science Foundation of China (81272053) funds were received to support this work.

No relevant financial activities outside the submitted work.

© 2013 by Lippincott Williams & Wilkins