Adolescent Idiopathic Scoliosis Case 21

Case Presentation #21: 17 year old female with Adolescent Idiopathic Scoliosis from Robert Pashman

A 17 year old female consulted with Dr. Pashman for a second opinion on scoliosis surgery. The patient presented with a 50 degree curve despite wearing her brace as instructed. She had a posterior spinal fusion.

    Case Review:

    17 year old female with Adolescent Idiopathic Scoliosis Curve progression despite bracing

    Patient History:

    16+9 year old female
    Adolescent Idiopathic Scoliosis
    Patient wore her brace with good compliance for 2 years
    Curve progression despite bracing
    2-cm right rib hump and elevation of left shoulder

    Indications for Surgery:

    1. Lenke 1A 50 degree of progressive adolescent idiopathic scoliosis.
    2. Failed conservative therapy including bracing.
    3. Now with increasing curve and upper thoracic pain.

    Surgical Strategy:

    T3 to L1 selective thoracic fusion for Lenke 1C progressive adolescent idiopathic scoliosis using quarter-inch stainless steel pedicle screw rod construct.
    Multiple level spinal osteotomy at T4 to T10, Smith-Pete osteotomies, radical facetectomies.
    Posterior spinal fusion, T3 to L1, using locally harvested autogenous bone and banked allograft.
    Intraoperative SSEPs and motor-evoked potentials.
    Intraoperative O-arm neuro navigation.

Related links:

Scoliosis overview
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
Scoliosis FAQ’s
Books about Scoliosis