Adolescent Idiopathic Scoliosis Case 15

Case Review #15: 13 year old female with Progressive Adolescent Idiopathic Scoliosis from Robert Pashman

A 13 year old female presented with thoracic and lumbar pain from Adolescent Idiopathic Scoliosis. The patient had a significant rib hump due to the spinal curvature. She was treated with a posterior spinal fusion.

    Case Review:

    13 year old female with Progressive Adolescent Idiopathic Scoliosis.

    Patient History:

    13 year old post-menarchal female. Progressive adolescent idiopathic scoliosis. Her left shoulder is slightly down from her right. The patient has failed conservative therapy. She has thoracic and lumbar pain.

    Indications for Surgery:

    1. Progressive adolescent idiopathic scoliosis, type 1AN 46° right thoracic curve.
    2. Significant pain, thoracic and lumbar spine.
    3. Cosmetic deformity of thoracic spine associated with progressive deformity.
    4. Failed conservative therapy.

    Surgical Strategy:

    Segmental spinal instrumentation, thoracic 3 to lumbar 1 using 5.5 stainless steel pedicle screw-rod construct. Multiple level osteotomies, T5 to T10, for loosening of thoracolumbar spine. Posterior spinal fusion, T3 to L1, using locally harvested autogenous bone and allograft bone. Interlaminar decompression at T12-L1 for adjacent segment flexibility and identification of pedicles of L1. Plastic closure of wound. Intraoperative SSEP and motor sensory evoked potential management. Intraoperative fluoroscopy management.

    Post-op Films:

    The patient did very well post- operatively. She resumed her favorite sporting activities at one year post-op.