An alternate method of fixation for management of early-onset deformity with thoracic kyphosis.

Abstract

Although methods currently used for management of early-onset scoliosis are effective, the presence of excessive thoracic kyphosis is associated with an increased instrumentation failure rate. An alternate method of upper thoracic fixation by using a 4-rib construct was developed by necessity when the author was presented with 2 cases of early-onset deformity with severe kyphosis and osteoporosis. With a minimum 3-year follow-up, both cases have demonstrated gratifying clinical and radiographic results. This method is presented as an alternate method of upper thoracic fixation when increased pullout forces secondary to thoracic kyphosis are anticipated. IV.