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Abstract
This Master thesis focuses on the correction mechanisms of costoplasty procedures and addresses the overall hypothesis that rib cage surgeries may influence the scoliotic deformities by mechanical means. The aims of this study are thus to develop a biomechanical modeling approach of rib surgeries, evaluate the potential correction of these techniques and formulate recommendations about the clinical use of costoplasties for the management of scoliosis.
A biomechanical finite element model has been used to virtually test various costoplasty options in order to address the project hypothesis. This model was built from patient specific geometric data using a tridimensional reconstruction technique of the spine and rib cage that has been developed at Sainte-Justine hospital and École Polytechnique de Montréal. The modeling feasibility was first tested on the geometry extracted from a scoliotic patient having a 72° thoracic Cobb angle. Then, a detailed biomechanical investigation of the correction mechanisms was made on an other scoliotic patient having a 46° thoracic Cobb angle. Finally, a complementary analysis was carried out to compare the mechanisms of action of the costoplasty procedures and the Cotrel-Dubousset spine instrumentation that were simulated either alone or in a concomitant way on 5 scoliotic patients. (Abstract shortened by UMI.)
