A 54 year old female presented with Adult Idiopathic Scoliosis. In addition to lower back pain, she noticed that her height was decreasing. Her spine was significantly rotated and she required a spinal fusion.
Adult Idiopathic Scoliosis, Double Curvature
54-year-old female.Adult Idiopathic Scoliosis.Her height has been decreasing.She has low back and upper back pain.Status post anterior interbody fusion of the cervicalspine. Fibromyalgia, Epstein-Barr, chronic fatigue syndrome. She has a combination of low back and leg pain.
Double curve that measure 57° thoracic, 67° lumbar
She is significantly rotated
Indications for Surgery:
1. Progressive adult idiopathic scoliosis, 57° thoracic, 67° lumbar.
2. Significant low back and leg pain due to the above diagnosis with lateral recess neural foraminal stenosis.
3. Multiple co-morbidities including fibromyalgia, Epstein- Barr, and chronic fatigue syndrome.
4. Failed conservative therapy.
5. Frontal and sagittal plane decompensation.
1. Segmental spinal instrumentation, thoracic 3 to sacral pelvis using pedicle screw-rod construct. This is a 15 level spinal fusion for adult idiopathic scoliosis.
2. Posterior spinal fusion, thoracic 3 to sacral pelvis using locally harvested autogenous bone and rhBMP.
3. 12-level spinal osteotomy with Smith-Peterson osteotomy, bilateral lateral facet resections for mobilization of adult idiopathic curve.
4. Interlaminar decompressions for lateral recess stenosis, Lumbar 1- 2, 2-3, 3-4, 4-5, and 5-1, bilaterally.
5. Intraoperative somatosensory-evoked potentials and motor- evoked potentials.
6. Intraoperative fluoroscopy.
7. Placement of Mayfield tong pin fixation for mobilization and positioning.
The patient is doing quite well. She has no significant complaints of pain. Her headaches have significantly reduced.
The patient is well-balanced in the frontal and sagittal plane. There is no appearance of hardware pull-out, and we are quite satisfied with her result.