Intraoperative push-prone test: A useful technique to determine the lowest instrumented vertebra in adolescent idiopathic scoliosis

Abstract

Study Design: A retrospective review of 24 cases of adolescent idiopathic scoliosis (AIS). Intraoperative push-prone test to determine the lowest instrumented vertebrae (LIV). Objective: To determine the LIV using intraoperative push-prone test. BACKGROUND: Determination of the LIV in surgical treatment of the AIS remains controversial. Different classifications schemes have been proposed to help surgeons in making this decision. Most schemes depend on flexibility views. However, variability in technique of obtaining flexibility views and interpretation of these views in relation to the classification schemes make decision making in choosing the LIV difficult. METHODS: An intraoperative push-prone image was used to determine LIV. Results: We were able to stop 1 or 2 levels above the stable vertebra in most cases. All patients had a well-balanced thorax over the pelvis. Conclusions: Intraoperative push-prone test is a useful adjunct to predict the LIV in AIS. © 2013 by Lippincott Williams & Wilkins.