Abstract
Aim:
To evaluate the effect of intraoperative manoeuvres on the rib hump.
Methods:
Patients with AIS and a thoracic rib hump that underwent a modified Suk technique of scoliosis correction were included. The Scoligauge (Ockenden net) scolimeter app was used to measure the rib hump in Adam's position and the prone position preoperatively. The Scoligauge was used again with the patient prone in theatre, at the end of exposure of the spine, after a 90 degree rod rotation manoeuvre (CD), after a segmental derotation manoeuvre (SDR) and finally at skin closure. The patients were consented for the use of the app on the senior author's mobile device. The device was double bagged for use in theatre.
Results:
A sample of 15 patients were enrolled. The biggest difference to the preoperative rib hump measurement seemed to come from simply lying the patient prone. The 90 degree rod rotation manoeuvre did not make a significant further change. In contrast, the segmental derotation manoeuvre did have a positive trend to further correction of the rib hump.
No infections occurred.
Discussion:
The prone position makes the biggest correction to the rib hump. Further correction is achieved with the SDR. The CD manoeuvre seems to make little difference to the rib hump. In this small study, there was a definite trend to improving the rib hump by lying prone and pursuing SDR. The numbers in this study are small, and the significance of the additional correction to patient outcome is unknown.
Conflict of interest:
Depuy-Synthes fund a fellow in our unit.
Conflict Of Interest Statement: No conflict of interest.
