What is a costoplasty or thoracoplasty?

I’ve been asked a few times about the costoplasty procedure I had at the time of my scoliosis surgery, so I thought I would try and answer a few common queries about costoplasties below.

When the spine curves it can also twist, this causes rotation of the rib cage which results in a “rib hump,” this mainly occurs with thoracic curves that affect the ribs. In my case I had a large thoracic curve and a very prominent “rib hump” on my right side, caused by the rotation of the spine. Some scoliosis curves can be large with very little rotation and some can be small with lots of rotation, every case is different.

A costoplasty, also called thoracoplasty, is a separate procedure to the spinal fusion, which can reduce the appearance of the “rib hump” that is most often associated with thoracic curves. 

A costoplasty will usually involve the removal of sections of several ribs that protrude – in my case my surgeon removed four sections of rib – ouch!!
The idea is that when the ribs grow back, they will grow back straight, providing you with a flatter back. This procedure can be carried out during the same time as the scoliosis surgery, or sometimes as a separate procedure after the spine has fused. 
Note that you can’t have a costoplasty without first having the spinal fusion to stabalise the spine.

 

Does everyone undergoing scoliosis surgery require a costoplasty?

No. Not everyone with scoliosis will require a costoplasty, it’s generally considered a “cosmetic” procedure. In many cases, especially with the modern instrumentation used nowadays, the surgeon can achieve a fantastic cosmetic outcome without the need for this additional procedure. Also, depending on where the curve is in the spine, the ribs may not be affected and therefore this procedure would not be required. It’s mainly required more for larger, stiffer thoracic curves (like mine). If you have a large rib hump as a result of your scoliosis and are considering spinal fusion, it would be worth discussing the options with your surgeon.

 

Are you pleased with the results?

Yes. Personally, I had a lot of rotation, my rib hump was very large and I hated it. It made me self-conscious and it was painful and uncomfortable to sit against chairs, this is why I decided to ask my surgeon about the costoplasty.

On reflection I am pleased I had this procedure and I would have it again tomorrow if I had to as the results were so fantastic. My rib hump has disappeared and I still can’t get over how flat my back looks even now. I don’t have many pictures of my rib hump side before surgery as I generally tried not to get that side photographed, however the below pictures shows how my rib hump looked before and after surgery:

Is having a costoplasty painful?

Yes it WAS painful, but that’s not much of a surprise really bearing in mind I had 4 broken ribs!  It hurt to breathe, sneeze, laugh, move!!

I would say the costoplasty pain was worse than the pain from my spine and lasted about 6 months. But for me the pain was all worth it and was controlled well with painkillers 🙂

It’s also worth noting that having a costoplasty adds time onto your recovery period – I had to wear a brace for 3 months to protect the healing ribs – whereas many patients are not required to wear a brace following scoliosis surgery. 

Are there additional risks to having a costoplasty?

Yes, as with any surgical procedure there are risks and complications that can occur with a costoplasty and you should always discuss all the options and risks with your surgeon before making a decision. For example, it lengthens the duration of the surgery and the time that you are under anesthetic.

Hope this helps please feel free to ask any further questions you may have about this procedure and I’ll do my best to help 🙂


Louise x

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