A 17 year old female with Progressive Adolescent Idiopathic Scoliosis presented to Dr. Pashman for a surgical opinion. The patient presented with a 36° thoracic curve which progressed to 48°. Dr. Pashman treated the patient with a posterior fusion T3-L1.

1. Case Review:
Progressive Adolescent
Idiopathic Scoliosis, treated
48°
with a posterior spinal fusion
T3-L1.
25°
Robert S Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com

2. Patient History
Patient followed from 15 years of age to 17 years of age
Curve progressed from 36° to 48°
Type 1A curve progressive curve with 2 cm right rib hump,
depression in the left shoulder, and a small flank fullness on
the left hand side. She is well balanced in the frontal-sagittal
plane and neurologically intact.

3. Pre-op X-rays
41° 48°
36°
25°
August 2007 March 2008 June 2008

4. Bending X-rays
Bending shows right 9°, left 19°. The patient will need a
selective thoracic fusion from T3 to approximately L1.

5. Indications for Surgery
A 48° type 1A and right thoracic progressive adolescent
idiopathic scoliosis.
Significant progression
Failure of conservative therapy.
Upper and low back pain due to the above diagnosis.

6. Surgical Strategy
1. Segmental spinal instrumentation using 5.5 pedicle screw and
rod stainless steel construct, thoracic 3 to lumbar 1.
2. Multiple level spinal osteotomy for release of spine including
radical facetectomy and takedown midline T5 to T11.
3. Posterior spinal fusion using locally harvested autogenous
bone and allograft bone T3 to L1.
4. Intraoperative SSEPs.
5. Intraoperative fluoroscopy.

7. Post-Op Films
15°
A 33° correction was
obtained. The patient is
balanced in both planes,
and her shoulders and hips
are even.

8. Pre-Op/Post-op Comparison
48° 15°
25°

9. Pre-Op/Post-op Comparison
The patient was very happy with her
outcome from a medical and
cosmetic standpoint. She continues
to feel good, and has returned to all
of her pre-surgery activities.