A 20 year old female from Mexico presented with 58 degree lumbar scoliosis. She was diagnosed at age 14, and was not prescribed a TLSO brace. Dr. Pashman performed a posterior spinal fusion on the patient.
20 year old female with Adult Idiopathic Scoliosis, 58° lumbar curvature, traveled from Mexico for surgical treatment.
A 20-year-old female
Diagnosed with Adolescent Idiopathic Scoliosis at age 14
Traveled from Mexico for treatment.
No bracing as a child/teenager
2 cm right rib flank fullness
Intermittent back pain
Tried conservative treatment including: traction, acupuncture, and chiropractic.
There is a sharp angular 58° lumbar curve apex at L2-3 to the right. The patient is decompensated approximately 1-2 cm to the right. The patient has a significant rotation angulation at L3-4.
The patients left side bending corrects to 8°, but still off midline. Right bending goes down to 38°. Right and left side bending films reveal moderate flexibility of the lumbar curve but increased correction on left side bending of L4 to S1.
Indications for Surgery:
1. Kim/SRP type 1, King type 5 lumbar adult idiopathic scoliosis 58 degrees.
2. Thoracolumbar kyphosis due to #1.
3. Low back pain.
4. Failed conservative therapy.
Segmental spinal instrumentation T11 to L4 using 1/4-inch stainless steel pedicle screw rod construct.
Posterior spinal fusion T11 to L4 using combination of autogenous allo and RH BMP bone T11 to L4.
Multiple level Smith-Petersen osteotomy for induction of flexibility of thoracolumbar kyphosis and stiff lumbar curve.
Intraoperative O-Arm neuronavigation management.
The patient is well balanced in the sagittal and coronal planes. Her curve was reduced from 58° to 22°. The patient returned to Mexico approximately 2 weeks following surgery, and then sent post-operative x-rays for review.