Thoracotomy

Many patients who develop scoliosis following thoracotomy have congenital heart disease,
[628,744]
but other
conditions requiring thoracotomy (e.g., repair of tracheoesophageal fistula) can also lead to scoliosis.
[763,796]
Most,
but not all, curves have the convexity toward the operated side. On occasion, two ribs fuse together at the
thoracotomy site and function as a tether. In this instance, the concavity of the scoliosis is toward the operated side.
Young patients who have a large number of ribs resected or who have undergone multiple thoracotomies are at a
higher risk for developing scoliosis.
[166,188]
Usually, resection of the posterior portion of the ribs leads to the
deformity. Anterior resection of the ribs does not tend to produce significant scoliosis.
Brace treatment for larger curves is usually ineffective, possibly because of the inability to apply corrective forces to
the abnormal chest wall. Operative intervention with posterior spinal instrumentation usually results in a successful
outcome.
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