A 20 year old female, with Adolescent Idiopathic Scoliosis. She deferred surgery until after college. Dr. Pashman performed a Posterior Spinal Fusion from T3-L1.
20 year old female with Adolescent Idiopathic Scoliosis, 58° curvature.
The patient was diagnosed with scoliosis at age 16 with a curvature measuring 40°
Her curvature continued to progress to 50°, and the patient opted to wait until after she graduated from college to proceed with surgery.
The patient is a top level swimmer and water polo player, and very athletic in general.
At the time of surgery, she was classified with a Type 2 curve that is 58° right thoracic with a structural upper thoracic curve measuring in excess of 45° with depression of the right shoulder.
The patient has flexibility of the lumbar compensatory curve and on right and left side bending compensates well through the L- 1 vertebra. The apex is at T11-10 and the patient has a 2 cm rib hump and was pre-oped for a thoracoplasty pending cosmetic results.
Indications for Surgery:
1. Kim/SRP type 1 type 2 adolescent/adult scoliosis, progressive, 58° thoracic curve.
2. Structural proximal thoracic curve
3. Documented progression with depression right shoulder.
4. Increasing upper and low back pain.
Segmental spinal instrumentation thoracic 3 to lumbar 1 using a 5.5 stainless steel pedicle screw rod construct.
Posterior spinal fusion, thoracic 3 to lumbar 1 using locally harvested autogenous bone, allograft putty and RH BMP.
Multiple level segmental osteotomy for fractional curve flexibility induction.
Smith-Peterson osteotomy, T4-5, T5-6, T6-7, T7-8, T8-9, T10-11 and T11-12.
Intraoperative O-arm neuronavigation.
Plastic closure of wound.
A 48° correction was obtained. The patient is well balanced in both the frontal and the sagittal planes. She is very happy with the outcome of her surgery.
Adolescent Idiopathic Scoliosis
Adult Idiopathic Surgical Cases performed by Dr. Pashman
Patient journal of scoliosis surgery, Patient follow-up journal four years after surgery
Bracing for Scoliosis
Books about Scoliosis