Journal of Orthopaedic Reports (Dec 2022)
A rare complication of correction surgery for adolescent idiopathic scoliosis requiring rib head resection: A case report
Abstract
Purpose: The objective of this case is to describe, for the first time, a case of adolescent idiopathic scoliosis treated with right sided transthoracic fusion and complicated by the cranial aspect of the rod boring through the fourth rib head. In this case we present a 25 year old female with idiopathic adolescent scoliosis who underwent transthoracic correction surgery in 2010. While initially coping well, she progressively developed pain in the right medial scapular region, at the level of T4, which was exacerbated by deep breathing. PET/CT scan showed increased uptake at the T4 rib head with the most cranial aspect of the rod boring itself into the head of the fourth rib. Principal results: Due to the challenge with removal of metalware, she proceeded for a right sided fourth rib head resection surgery a decade after her primary surgery. She experienced immediate resolution of pain. She has remained asymptomatic with complete resolution of pain beyond one year follow up. Major conclusions: With this case report we hope to raise awareness of this rare complication of transthoracic correction surgery. It would be prudent for clinicians managing patients with scoliosis to consider rib head pathology should new pain arise following surgery.Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
