Assuntos
Complicações Intraoperatórias/terapia , Guias de Prática Clínica como Assunto , Escoliose/cirurgia , Traumatismos da Medula Espinal/terapia , Fusão Vertebral/efeitos adversos , Adolescente , Adulto , Algoritmos , Criança , Terapia Combinada , Contraindicações , Drenagem , Humanos , Hipotermia Induzida , Fixadores Internos/efeitos adversos , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/prevenção & controle , Hipertensão Intracraniana/cirurgia , Complicações Intraoperatórias/tratamento farmacológico , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Isquemia/etiologia , Isquemia/prevenção & controle , Isquemia/terapia , Metilprednisolona/uso terapêutico , Monitorização Intraoperatória/métodos , Monitorização Intraoperatória/estatística & dados numéricos , Fármacos Neuroprotetores/uso terapêutico , Medula Espinal/irrigação sanguínea , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/prevenção & controleRESUMO
The rib hump is a protrusion of the apicals ribs of the convex side of the toracic scoliosis and it is due to the torsional deformity that appears in scoliosis. It originates a great cosmetic deformity that although improves with the correction of the scoliosis, it appears again by the costal elasticity. For this reason, in cases of important deformity it is necessary to associate a costoplasty for its definitive improvement. 10 cases of Idiopatic Scoliosis with 75.5 degrees of average and rib hump of 22.1 degrees were analysed. A resection of apicals ribs without stabilization in the same surgical act were done; the correction of the curve was 34.6 degrees (55%) and of the hump 8.1 degrees (64%); there were no important complications and the postoperative evolution was normal. The average follow up was 21,9 months, only in 1 case a slight deterioration of the hump was detected, although in all the cases the ribs recovered. In conclusion, costoplasty breaks the vertebro-bicosto-esternal ring. For that reason it is effective for the improvement of the costal hump without adding morbidity to the correction of the scoliosis.