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Biomechanical investigation of potential prophylactic scoliosis treatments following various sizes of chest wall resection
Journal article   Peer reviewed

Biomechanical investigation of potential prophylactic scoliosis treatments following various sizes of chest wall resection

Zackery W. Witte, Jonathan M. Mahoney, Jonathan A. Harris, Hassaan P. Sheikh, Varan Haghshenas, Brandon S. Bucklen and Rex A. Marco
Clinical biomechanics (Bristol), v 87, 105416
01 Jul 2021
DOI: https://doi.org/10.1016/j.clinbiomech.2021.105416
PMID: 34171652
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Engineering, Biomedical Life Sciences & Biomedicine Science & Technology Sport Sciences Engineering Orthopedics Technology
Background: A well-known problematic sequela of chest wall resections is development of scoliosis. Despite the seriousness and frequency of scoliosis following chest well resection, the etiology and biomechanical information needed to understand this progression aren't well-known. Methods: Range of motion of six specimen (C7-L2) was captured using a custom-built six degrees-of-freedom machine in each of three physiological rotation axes. Left posterior ribs were sequentially resected 7cm from the rib head, starting at the 5th rib and continuing until the 10th rib. Injured specimen were instrumented with unilateral anterior rod fixation and then with additional unilateral posterior fixation, each starting at T4 and then extended distally as ribs were resected. Relative motion between the constructs' proximal and distal ends was measured in all three axes for the intact, injured, unilateral anterior, and unilateral anterior with unilateral posterior constructs. Findings: Raw motion of the injured specimen increased in a stepwise manner as ribs were resected. Averaged across all injury sizes, the unilateral anterior construct significantly reduced motion by 47.0 +/- 13.4% in lateral bending (P=.001). The combined anterior-posterior construct significantly reduced motion by 57.6 +/- 15.9% in flexion/extension (P<.001), 70.3 +/- 12.2% in lateral bending (P<.001), and 51.1 +/- 14.5% in axial rotation (P<.001). Combined anterior-posterior fixation was significantly more stable than anterior-only fixation in flexion/extension (P=.002). Interpretation: Regardless of injury size, posterior rib resection did not create significant immediate instability of the thoracic spine. Concurrent spinal stabilization was shown to maintain thoracic spine stability. Combined anterior-posterior fixation proved to be significantly more rigid than an anterior-only construct.

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1 citations in Web of Science
1 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Engineering, Biomedical
Orthopedics
Sport Sciences
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