The rib hump after surgery for early onset spinal deformity

Spinal deformity presenting early in childhood has a poor prognosis, in that progression is probable and severe respiratory compromise is a real possibility. Treatment is difficult, since these patients frequently do not respond to bracing, and surgery is sometimes performed in childhood in an attempt to control relentless progression. This carries the risk of continued deformation during subsequent growth, and the surgical procedures have been adapted in an attempt to minimise this. 25 children undergoing spinal fusion for progressive and severe deformity have sequential topographic scans which show that, despite measures to control the rib hump, progression after surgery is the rule.