Abstract
Purpose: To introduce our new surgical technique for better correction of scoliosis and rib hump deformity.
Surgical technique: The technique consists of rib mobilization (RM) and hook rotation maneuver (HRM). RM is to release costo-vertebral connection bilaterally from T5 to T10 to mobilize ribs obtaining more flexibility of the spine. HRM is to rotate convex side hooks on transverse process ventrally pushing down the ribs, thus giving derotational force while compression force is applied.
Subjects: Forty-six idiopathic cases with minimum 1 year follow-up were reviewed. The average F-up period is 15.1m( 12 – 24). The average age at surgery was 20.1 y(12–57). Conventional multiple hooks, screws, wires and rod system was used. Results: The average Cobb angle was 56.0 ( 40 – 93) degrees. The average rib hump was 22.5 mm in height and 13.9 degrees by scoliometer. At 3 w post-op, 6 m post-op, and at F-up, the average Cobb angle was 13.0 (77.9%), 15.6 (73.4%), and 16.0 (72.6%, 43 – 100%)) respectively. The average rib hump at 6m post-op and at F-up was 9.7 mm in height and 6.8 degrees, and 10.3mm and 6.4 degrees respectively. The hump index at thoracic level was 5.49 pre-op, 3.73 at 6m and 4.25 at F-up.
Conclusion: Our new technique improved the correction of not only scoliosis but also thoracic hump significantly. The derotational force by HRM is weaker than direct derotation by pedicle screw. However, it is undoubtedly a safer and less expensive technique than thoracic pedicle screw, providing significant correction of rib hump.
Correspondence should be addressed to BSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
