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A biomechanical study on the effects of rib head release on thoracic spinal motion

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Abstract

Purpose

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.

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References

  1. Andriacchi T, Schultz A, Belytschko T, Galante J (1974) A model for studies of mechanical interactions between the human spine and rib cage. J Biomech 7:497–507

    Article  PubMed  CAS  Google Scholar 

  2. Cheng I, Hay D, Iezza A, Lindsey D, Lenke LG (2010) Biomechanical analysis of derotation of the thoracic spine using pedicle screws. Spine 35:1039–1043

    Article  PubMed  Google Scholar 

  3. Horton WC, Kraiwattanapong C, Akamaru T, Minamide A, Park JS, Park, Hutton WC (2005) The role of the sternum, costosternal articulations, intervertebral disc, and facets in thoracic sagittal plane biomechanics: a comparison of three different sequences of surgical release. Spine 30:2014–2023

    Article  PubMed  Google Scholar 

  4. Oda I, Abumi K, Cunningham BW, Kaneda K, McAfee PC (2002) An in vitro human cadaveric study investigating the biomechanical properties of the thoracic spine. Spine 27:E64–E70

    Article  PubMed  Google Scholar 

  5. Oda I, Abumi K, Lu D, Shono Y, Kaneda K (1996) Biomechanical role of the posterior elements, costovertebral joints, and rib cage in the stability of the thoracic spine. Spine 21:1423–1429

    Article  PubMed  CAS  Google Scholar 

  6. Takeuchi T, Abumi K, Shono Y, Oda I, Kaneda K (1999) Biomechanical role of the intervertebral disc and costovertebral joint in stability of the thoracic spine. A canine model study. Spine 24:1414–1420

    Article  PubMed  CAS  Google Scholar 

  7. Watkins RT, Watkins R III, Williams L, Ahlbrand S, Garcia R, Karamanian A, Sharp L, Vo c, Hedman T (2005) Stability provided by the sternum and rib cage in the thoracic spine. Spine 30:1283–1286

    Article  PubMed  Google Scholar 

  8. Lee SM, Suk SI, Chung ER (2004) Direct vertebral rotation: a new technique of three-dimensional deformity correction with segmental pedicle screw fixation in adolescent idiopathic scoliosis. Spine 29:343–349

    Article  PubMed  Google Scholar 

  9. Ecker ML, Betz RR, Trent PS, Mahboubi S, Mesgarzadeh M, Bonakdapour A, Drummond DS, Clancy M (1988) Computer tomography evaluation of Cotrel-Dubousset instrumentation in idiopathic scoliosis. Spine 13:1141–1144

    Article  PubMed  CAS  Google Scholar 

  10. Soultanis K, Pyrovolou N, Karamitros A, Konstantinou V, Lenti A, Soucacos PN (2006) The use of thoracoplasty in the surgical treatment of idiopathic scoliosis. Stud Health Technol Inform 123:327–333

    PubMed  CAS  Google Scholar 

  11. Suzuki N, Kono K (2010) Super hybrid method of scoliosis correction: minimum 2-year follow-up. Stud Health Technol Inform 158:147–151

    PubMed  Google Scholar 

  12. Hsu CJ, Chang YW, Chou WY, Chiou CP, Chang WN, Wong CY (2008) Measurement of spinal range of motion in healthy individuals using an electromagnetic tracking device. J Neurosurg Spine 8:135–142

    Article  PubMed  Google Scholar 

  13. Lam KS, Mehdian H (1999) The importance of an intact abdominal musculature mechanism in maintaining spinal sagittal balance. Case illustration in prune-belly syndrome. Spine 24:719–722

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

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Authors and Affiliations

  1. Showa Ika Kohgyo Company, Toyohashi, Japan

    Xianfeng Yao

  2. Department of Orthopedics, The Spine Center at the University of Colorado Denver, 12631 E. 17th Ave, Denver, CO, 80045, USA

    Thomas J. Blount, Laura K. Brown, Christiaan J. van der Walt, Todd Baldini, Emily M. Lindley, Vikas V. Patel & Evalina L. Burger

  3. Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan

    Nobumasa Suzuki

Authors
  1. Xianfeng Yao
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  2. Thomas J. Blount
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  3. Nobumasa Suzuki
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  4. Laura K. Brown
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  5. Christiaan J. van der Walt
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  6. Todd Baldini
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  7. Emily M. Lindley
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  8. Vikas V. Patel
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  9. Evalina L. Burger
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Corresponding author

Correspondence to Vikas V. Patel.

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Yao, X., Blount, T.J., Suzuki, N. et al. A biomechanical study on the effects of rib head release on thoracic spinal motion. Eur Spine J 21, 606–612 (2012). https://doi.org/10.1007/s00586-011-2031-z

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  • DOI: https://doi.org/10.1007/s00586-011-2031-z

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