Adolescent Idiopathic Scoliosis Case 5

Case Review #5: 14 year old female with Adolescent Idiopathic Scoliosis from Robert Pashman

14 year old female with adolescent idiopathic scoliosis. The curve progressed to 65° despite bracing. Dr. Pashman performed a posterior spinal fusion and had complete correction of her curvature.

    Case Review: 

    Adolescent Idiopathic Scoliosis with a 65° curve

    Patient History:

    14-year-old female Adolescent Idiopathic Scoliosis Lenke 1AN curve
    65° Progressive curve
    Failed bracing
    The patient has a right rib hump 2 cm

    Indications for Surgery:

    Progressive 65-degree Lenke 1A in curve.
    Failure of conservative therapy.
    Low back pain.

    Surgical Strategy:

    Segmental spinal instrumentation, thoracic 3 to lumbar 1using  5.5 stainless steel pedicle screw rod construct.
    Radical facetectomy, multiple level osteotomy T4-T12 with removal of facet and joints bilaterally.
    Posterior spinal fusion, thoracic 3 to lumbar 1 using locally harvested autogenous bone, spinous processes, facetectomy and dorsal lamina mixed with allograft bone.
    Intraoperative somatosensory-evoked potential (SSEP) and motor-evoked potential interpretation.
    Intraoperative fluoroscopy interpretation.

    Post-Op Films:

    At the time of operation resolution of the thoracic rib hump on derotation was noticed, therefore, a thoracoplasty was avoided

    Pre-Op/Post-op Comparison:

    X-rays show almost complete correction of the scoliosis from 65° to 0° with excellent balance. The patient is doing well. Cosmetically, she has had an excellent result.

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