Case Review:      54°      35 year old female with               Progressive Adult92°               Idiopathic Scoliosis. ...
Patient History                      • 35-year-old female                      • Progressive Kim/SRP type                 ...
Bending X-rays             Bending films show             neutralization and             middle stable             Harring...
Indications for Surgery1. Progressive adult idiopathic scoliosis, Kim / Sagittal   Reconstruction Parameters type I, 5490 ...
Surgical Strategy• Segmental spinal instrumentation thoracic 3 to lumbar 3 using  1/4- inch stainless steel pedicle screw ...
Surgical Strategy – cont.• Motor evoked potentials.• Intraoperative fluoroscopic control.• O arm CT intraoperative interpr...
Post-op Films             • The patient is well balanced               in both the sagittal and               coronal plan...
Pre-Op/Post-op Comparison      54°            55°92°      38°
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Case Review #41: 35 year old female with a 92 degree Scoliosis

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A 35 year old female presented with Adult Idiopathic Scoliosis. Her thoracic curvature measured 92 degrees. The patient was experiencing upper and lower back pain. Dr. Pashman performed a posterior spinal fusion on the patient.

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Case Review #41: 35 year old female with a 92 degree Scoliosis

  1. 1. Case Review: 54° 35 year old female with Progressive Adult92° Idiopathic Scoliosis. Thoracic curve measuring 92° 38° Robert S Pashman, MD Scoliosis and Spinal Deformity Surgery www.eSpine.com
  2. 2. Patient History • 35-year-old female • Progressive Kim/SRP type I Adult Idiopathic 54° Scoliosis • Major thoracic curve measuring in excess of 9292° degrees 58° • Significant rotation and 38° deformity. • Upper and lower back pain.
  3. 3. Bending X-rays Bending films show neutralization and middle stable Harrington, plumb line S1-L4.
  4. 4. Indications for Surgery1. Progressive adult idiopathic scoliosis, Kim / Sagittal Reconstruction Parameters type I, 5490 for 38° progressive curvature with rotation deformity.2. Significant upper back and low back pain due to progressive deformity.3. Failed conservative therapy.
  5. 5. Surgical Strategy• Segmental spinal instrumentation thoracic 3 to lumbar 3 using 1/4- inch stainless steel pedicle screw rod construct.• Posterior spinal fusion using locally harvested autogenous bone Rh bone morphogenic protein and extender T3 to L3.• Multiple level spinal osteotomy through ankylosed concave, convex spine for inducement of flexibility thoracic 5-6, thoracic 6-7, thoracic 8-9, thoracic 9-10 and thoracic 11-12.• Interlaminar laminectomy, mesial facetectomy and lateral recess release for lateral recess stenosis and pedicle visualization lumbar 1-2 and lumbar 2-3 bilaterally.
  6. 6. Surgical Strategy – cont.• Motor evoked potentials.• Intraoperative fluoroscopic control.• O arm CT intraoperative interpretation and neuronavigation guidance thoracic spine.
  7. 7. Post-op Films • The patient is well balanced in both the sagittal and coronal planes. • The patient’s main curve was reduced from 92° to 55°.55° • She gained almost 2 inches in height, and has minimal pain.
  8. 8. Pre-Op/Post-op Comparison 54° 55°92° 38°

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