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Rib cage asymmetry in idiopathic scoliosis
Author(s) -
Stokes Ian A. F.,
Dansereau Jean,
Moreland Morey S.
Publication year - 1989
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.1100070419
Subject(s) - rib cage , idiopathic scoliosis , scoliosis , asymmetry , cage , physical medicine and rehabilitation , orthodontics , medicine , anatomy , psychology , physics , surgery , engineering , structural engineering , quantum mechanics
Seventy‐one patients attending a scoliosis clinic and 10 control subjects were studied by a stereoradiographic three‐dimensional reconstruction of the spine and rib cage. The symmetry of each rib pair (at each anatomic level) was described by measurements of rib arc length, chord length, enclosed area, maximum curvature, and frontal and lateral angulations. Patients were divided into four groups: 19 with a single right thoracic curve, 15 with a single left lumbar or thoracolumbar curve, 22 with double curves, and 15 with a curve with 10° Cobb angle. In the control group and the group with minimal scoliosis, there was no statistically significant rib asymmetry. Among the patients with scoliosis, 11 of 19 patients with right single thoracic curves had rib arc lengths greater on the right side at the curve apex, and nine of 15 patients with left lumbar scoliosis had longer ribs on the left side in the corresponding region of the thoracic spine. Eleven of 22 patients with double curves had symmetrical rib lengths (within ∼3%), the other 11 had ribs longer on the left. These proportions should not have occurred by chance (p < 0.001). The mean rib length difference in patients with single thoracic curves was 1.39% (right longer than left), in single lumbar curves it was 3.57% (left longer than right), and in double curves 3.18% (left longer than right). These differences between the groups of patients and control subjects were statistically significant (p < 0.01). Based on correlations between rib arc length and other measurements of rib size, there was evidence of general rib hypertrophy on the long rib side of patients having length asymmetries.