57 year old female with Adult Idiopathic Scoliosis. She presented with a 62 degree thoracolumbar curve. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. Dr. Pashman took great care with incision closure to preserve the patient’s tattoo. KIM/SRP Classification 2.
57 year old female with Adult Idiopathic Scoliosis
57 year old female
Adult Idiopathic Scoliosis, Kim/SRP Type 3
Patient is a weightlifter, in is in good physical shape.
Patient reports losing height and progressive deformity.
The patient has a 62° thoracolumbar curve, with severe degeneration of L4-5 and L5-S1 at the fractional concavity. The patient is well-balanced in the sagittal plane. The thoracolumbar curve extends past the thoracolumbar junction and down to the sacrum.
Indications for Surgery:
1. Kim/SRP type 3 adult idiopathic scoliosis.
2. Severe degenerative lumbosacral oblique take-off.
3. Coronal and sagittal plane decompensation.
4. Unremitting low back and lower extremity radiculopathy due to the above diagnosis.
5. Failed conservative therapy.
Abdominal retroperitoneal Segmental spinal instrumentation, T10 to approach to the lumbosacral spine sacral pelvis, using titanium pedicle screw,
Radical diskectomy L4-5, L5-S1 5.5 rod instrumentation with epidural decompression.
Posterior spinal fusion, T10 to the sacral
Interbody fusion with PEEK pelvis using locally harvested autogenous device, 8 mm at L4-5, and an FRA bone and allograft PEEK measuring 11 mm at L5-S1,both with combination of allograft Smith-Peterson osteotomy for looseningand rhBMP centrally of lumbar spine, T10-11, T11- 12, T12-L1
Anterior screw fixation, L4-5, L5- L1-2, L2-3 and L4-5.S1.
Lateral recess decompression L3-4
Intraoperative fluoroscopic L4-5.control.
Intraoperative O-ARM neuronavigation with Stealth system.
Intraoperative somatosensory evoked potentials and motor evoked potentials.
Plastic closure of wound.
The patient is perfectly balanced in the sagittal plan.