Case Presentation #8: 14 year old female presented with Adolescent Idiopathic...Robert Pashman
A 14 year old girl presented with 38 degree Adolescent Idiopathic Scoliosis. The curve progressed within a few months, and she required scoliosis surgery. Dr. Pashman performed a posterior spinal fusion on her.
Case Review #22: 21 year old with Progressive Adolescent Idiopathic ScoliosisRobert Pashman
A 21 year old female presented to Dr. Pashman with Progressive Adolescent Idiopathic Scoliosis. The patient had been followed for scoliosis, and was compliant wearing her brace. Her spinal curvature progressed despite physical therapy and bracing. Dr. Pashman treated her with a Posterior Spinal Fusion T3-L1.
Case Review #11: Progressive Adolescent Idiopathic ScoliosisRobert Pashman
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.
Case Review #10: 12 year old girl with 70 degree Scoliosis Robert Pashman
A 12 year old girl presented with a 70 degree adolescent idiopathic scoliosis discovered during a routine school screening. Dr. Pashman performed a posterior spinal fusion on the patient.
Case Review #12: 14 Year Old Female with Adolescent Idiopathic ScoliosisRobert Pashman
A 14 year old female presented with Adolescent Idiopathic Scoliosis. The patient was non-compliant with bracing. The Scoliosis curvature and Kyphosis curvature progressed, and she required surgery.
Case Review #1: 13 year old female with Scheurmanns KyphosisRobert Pashman
A 13 year old female presented with Kyphosis. She had a 75° curvature. Dr. Pashman performed a posterior spinal fusion T2-L2 and obtained a 44% reduction in her curvature.
Case Review #9: Adult Idiopathic Scoliosis with a Double CurvatureRobert Pashman
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.
Case Review #6: 53 year old woman with Adult ScoliosisRobert Pashman
A 53 year old woman, with an 85° thoracic curve, and a 75° lumbar curve. Dr. Pashman treated her with an Anterior fusion followed by a Posterior Spinal Fusion from T1 to the Pelvis. Curve was a KIM/SRP Classification 3.
Case Presentation #8: 14 year old female presented with Adolescent Idiopathic...Robert Pashman
A 14 year old girl presented with 38 degree Adolescent Idiopathic Scoliosis. The curve progressed within a few months, and she required scoliosis surgery. Dr. Pashman performed a posterior spinal fusion on her.
Case Review #22: 21 year old with Progressive Adolescent Idiopathic ScoliosisRobert Pashman
A 21 year old female presented to Dr. Pashman with Progressive Adolescent Idiopathic Scoliosis. The patient had been followed for scoliosis, and was compliant wearing her brace. Her spinal curvature progressed despite physical therapy and bracing. Dr. Pashman treated her with a Posterior Spinal Fusion T3-L1.
Case Review #11: Progressive Adolescent Idiopathic ScoliosisRobert Pashman
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.
Case Review #10: 12 year old girl with 70 degree Scoliosis Robert Pashman
A 12 year old girl presented with a 70 degree adolescent idiopathic scoliosis discovered during a routine school screening. Dr. Pashman performed a posterior spinal fusion on the patient.
Case Review #12: 14 Year Old Female with Adolescent Idiopathic ScoliosisRobert Pashman
A 14 year old female presented with Adolescent Idiopathic Scoliosis. The patient was non-compliant with bracing. The Scoliosis curvature and Kyphosis curvature progressed, and she required surgery.
Case Review #1: 13 year old female with Scheurmanns KyphosisRobert Pashman
A 13 year old female presented with Kyphosis. She had a 75° curvature. Dr. Pashman performed a posterior spinal fusion T2-L2 and obtained a 44% reduction in her curvature.
Case Review #9: Adult Idiopathic Scoliosis with a Double CurvatureRobert Pashman
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.
Case Review #6: 53 year old woman with Adult ScoliosisRobert Pashman
A 53 year old woman, with an 85° thoracic curve, and a 75° lumbar curve. Dr. Pashman treated her with an Anterior fusion followed by a Posterior Spinal Fusion from T1 to the Pelvis. Curve was a KIM/SRP Classification 3.
Case Review #43: 43 year old female with Adult Idiopathic Scoliosi requiring...Robert Pashman
1. A 43-year old female with adult idiopathic scoliosis underwent anterior spinal surgery with instrumentation from T12 to L3 to correct curves of 60° thoracic and 57° lumbar, reducing them to 41°.
2. A 48-year old female with Kim/SRP type III scoliosis underwent revision surgery with anterior lumbar interbody fusion from L4-S1 and posterior spinal fusion from T3 to S1 to correct increasing proximal thoracic curvature and subadjacent degeneration.
3. Post-operatively, the patient was well-balanced in sagittal and coronal planes with thoracic and lumbar curves reduced to 26° and 27° respectively.
Case Review #42: 39 year old female with Adult Congenital ScoliosisRobert Pashman
A 39 year old female with Congenital Scoliosis presented to Dr. Pashman. The patient had a fusion at age six, and her spinal curve continued to progress. Dr. Pashman treated the patient with a posterior spinal fusion from T3-Pelvis. KIM/SRP Classification 3.
Case Review #24: 67 year old female with Degenerative ScoliosisRobert Pashman
67 year old female presented with DeNovo Scoliosis, with significant rotation due to Adolescent Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. KIM/SRP Classification 2.
Case Review #8: 44 year old woman presented with a Double Major Scoliosis Cur...Robert Pashman
A 44 year old female presented with Adult Idiopathic Scoliosis with a double major curve. Dr. Pashman treated the patient with a Posterior Spinal Fusion T3-L4. KIM/SRP Classification 1.
Case Review #8: A 29 year old female firefigher presented with Scheurmanns Ky...Robert Pashman
A 29 year old female firefighter, diagnosed with progressive Scheurmann's Kyphosis. She presented status post surgery T12-L1 for trauma. Dr. Pashman treated the patient with a Posterior Spinal Fusion from T2 to L2.
Case Review #23: 15 year old male with Adolescent Idiopathic ScoliosisScoliosisRobert Pashman
A very active 15 year old male presented with progressive Adolescent Idiopathic Scoliosis. His curve progressed after a recent growth spurt. The patient had scoliosis surgery, and returned to ROTC.
Case Review 4: A 58 year old female presented with Scheurmann's KyphosisRobert Pashman
A 58-year-old female with severe rigid thoracolumbar kyphosis due to Scheuermann's disease and degeneration underwent a posterior spinal fusion from T2 to the pelvis. She had a 70 degree curvature that was rigid. The surgery involved segmental spinal instrumentation, multiple osteotomies to correct the curvature, decompression of neural elements, and an 18-level posterior fusion. Post-operatively, the patient's curvature was fully corrected and she gained 2 inches in height.
Case Review #1: 39 year old female with Congenital Scoliosis Robert Pashman
A 39-year-old female with progressive congenital scoliosis underwent spinal fusion from T3 to the pelvis. She had a previous fusion at age 6 but her curvature had worsened. The surgery included multiple osteotomies and instrumentation to correct her frontal and sagittal plane deformities. Post-operatively, her curvature was reduced from 31 to 18 degrees and she had improved balance and pain relief.
Case Review #50: 29 year old woman presents with dislodged instrumentation fo...Robert Pashman
A 29-year old woman presented with dislodged hardware from three previous surgeries for adolescent idiopathic scoliosis. She had retained loose instrumentation from her past operations that posed a medical risk. The surgical strategy was to remove the retained hardware through osteotomies, perform spinal fusions from T4 to L3, and place new segmental instrumentation from L2 to L3.
Case Review 15: Adult Scoliosis treated with Spinal Fusion and OteotomiesRobert Pashman
A 50 year old female presented with progressive Adult Idiopathic Scoliosis. The patient had severe low back pain and leg pain. She was treated with a posterior spinal fusion with spinal osteotomies.
Case Review #2: 41 year old female presented with Adult Scoliosis and Spodylo...Robert Pashman
A 41 year old female with a 50° thoracolumbar curve and Spondylolisthesis. Dr. Pashman treated the patient with an Posterior Spinal Fusion from T10-Pelvis. Her curve was a KIM/SRP Classification 2.
Case Review #15: 13 year old female with Profressive Adolescent Idiopathic Sc...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 #25: 39 year old female with Progressive Adult ScoliosisRobert Pashman
39 year old female presented with Progressive Adult Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T3-L4. KIM/SRP Classification 1
Case Review #9: 19 year old female with Scheuermann's DiseaseRobert Pashman
A 19 year old female from Las Vegas traveled to Los Angeles for treatment. She presented with progressive Scheurmann's Kyphosis. The patient is an equestrian rider and model. Dr. Pashman treated the patient with a Posterior Spinal Fusion from T3 to L1. She returned to modeling a few months post-op, and returned to horseback riding at 6 months post-op.
Case Review #7: Progressive Adult Idiopathic Scoliosis with a 75 degree curva...Robert Pashman
The patient, a 19-year-old female, presented with a progressive 75° thoracic scoliosis that had increased 21° over four years and was causing her significant pain. Pre-operative images showed the curvature was rigid. The surgical plan was to perform segmental spinal instrumentation from T3 to L1, posterior spinal fusion from T3 to L2, and spinal osteotomies from T4 to T9 to correct the rigid curvature. Post-operatively, a 43° correction was achieved, reducing the curvature to 27°, and the patient was able to resume her normal activities with no restrictions after one year.
Case Review #B: 20 year old with Adolescent Idiopathic ScoliosisRobert Pashman
20 year old female with a 48° primary thoracolumbar curve with a compensatory 34° thoracic curve. Dr. Pashman treated the patient with a thoracolumbar anterior spinal fusion.
Case Review #24: A 15 Year Old Female with Adolescent Idiopathic ScoliosisRobert Pashman
Dr. Pashman followed the patient for three years. After a growth spurt, her scoliosis curvature progressed significantly, and she required scoliosis surgery.
Case Review #51: 59 year old Female with Collapsing ScoliosisRobert Pashman
A 59 year old female presented to Dr. Pashman with a 60 degree throacic curve, in extreme pain. She failed conservative therapy and opted to have scoliosis surgery.
Case Review #16: 59 year old woman with 25 year history of Adult Idiopathic S...Robert Pashman
59 year old female presented with 25 year history of scoliosis progression. 68° thoracic curve, 42° lumbar curve. Dr. Pashman treated her with a fusion T3-L4. KIM/SRP Classification 1.
Case Review #21: Triple Curvature Adult Idiopathic ScoliosisRobert Pashman
A 23 year old male presented with a triple adult idiopathic scoliosis curvature. The curvature progressed despite bracing. Dr. Pashman performed a spinal fusion from T4-L3.
Case Review #43: 43 year old female with Adult Idiopathic Scoliosi requiring...Robert Pashman
1. A 43-year old female with adult idiopathic scoliosis underwent anterior spinal surgery with instrumentation from T12 to L3 to correct curves of 60° thoracic and 57° lumbar, reducing them to 41°.
2. A 48-year old female with Kim/SRP type III scoliosis underwent revision surgery with anterior lumbar interbody fusion from L4-S1 and posterior spinal fusion from T3 to S1 to correct increasing proximal thoracic curvature and subadjacent degeneration.
3. Post-operatively, the patient was well-balanced in sagittal and coronal planes with thoracic and lumbar curves reduced to 26° and 27° respectively.
Case Review #42: 39 year old female with Adult Congenital ScoliosisRobert Pashman
A 39 year old female with Congenital Scoliosis presented to Dr. Pashman. The patient had a fusion at age six, and her spinal curve continued to progress. Dr. Pashman treated the patient with a posterior spinal fusion from T3-Pelvis. KIM/SRP Classification 3.
Case Review #24: 67 year old female with Degenerative ScoliosisRobert Pashman
67 year old female presented with DeNovo Scoliosis, with significant rotation due to Adolescent Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. KIM/SRP Classification 2.
Case Review #8: 44 year old woman presented with a Double Major Scoliosis Cur...Robert Pashman
A 44 year old female presented with Adult Idiopathic Scoliosis with a double major curve. Dr. Pashman treated the patient with a Posterior Spinal Fusion T3-L4. KIM/SRP Classification 1.
Case Review #8: A 29 year old female firefigher presented with Scheurmanns Ky...Robert Pashman
A 29 year old female firefighter, diagnosed with progressive Scheurmann's Kyphosis. She presented status post surgery T12-L1 for trauma. Dr. Pashman treated the patient with a Posterior Spinal Fusion from T2 to L2.
Case Review #23: 15 year old male with Adolescent Idiopathic ScoliosisScoliosisRobert Pashman
A very active 15 year old male presented with progressive Adolescent Idiopathic Scoliosis. His curve progressed after a recent growth spurt. The patient had scoliosis surgery, and returned to ROTC.
Case Review 4: A 58 year old female presented with Scheurmann's KyphosisRobert Pashman
A 58-year-old female with severe rigid thoracolumbar kyphosis due to Scheuermann's disease and degeneration underwent a posterior spinal fusion from T2 to the pelvis. She had a 70 degree curvature that was rigid. The surgery involved segmental spinal instrumentation, multiple osteotomies to correct the curvature, decompression of neural elements, and an 18-level posterior fusion. Post-operatively, the patient's curvature was fully corrected and she gained 2 inches in height.
Case Review #1: 39 year old female with Congenital Scoliosis Robert Pashman
A 39-year-old female with progressive congenital scoliosis underwent spinal fusion from T3 to the pelvis. She had a previous fusion at age 6 but her curvature had worsened. The surgery included multiple osteotomies and instrumentation to correct her frontal and sagittal plane deformities. Post-operatively, her curvature was reduced from 31 to 18 degrees and she had improved balance and pain relief.
Case Review #50: 29 year old woman presents with dislodged instrumentation fo...Robert Pashman
A 29-year old woman presented with dislodged hardware from three previous surgeries for adolescent idiopathic scoliosis. She had retained loose instrumentation from her past operations that posed a medical risk. The surgical strategy was to remove the retained hardware through osteotomies, perform spinal fusions from T4 to L3, and place new segmental instrumentation from L2 to L3.
Case Review 15: Adult Scoliosis treated with Spinal Fusion and OteotomiesRobert Pashman
A 50 year old female presented with progressive Adult Idiopathic Scoliosis. The patient had severe low back pain and leg pain. She was treated with a posterior spinal fusion with spinal osteotomies.
Case Review #2: 41 year old female presented with Adult Scoliosis and Spodylo...Robert Pashman
A 41 year old female with a 50° thoracolumbar curve and Spondylolisthesis. Dr. Pashman treated the patient with an Posterior Spinal Fusion from T10-Pelvis. Her curve was a KIM/SRP Classification 2.
Case Review #15: 13 year old female with Profressive Adolescent Idiopathic Sc...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 #25: 39 year old female with Progressive Adult ScoliosisRobert Pashman
39 year old female presented with Progressive Adult Idiopathic Scoliosis. Dr. Pashman treated the patient with a posterior spinal fusion from T3-L4. KIM/SRP Classification 1
Case Review #9: 19 year old female with Scheuermann's DiseaseRobert Pashman
A 19 year old female from Las Vegas traveled to Los Angeles for treatment. She presented with progressive Scheurmann's Kyphosis. The patient is an equestrian rider and model. Dr. Pashman treated the patient with a Posterior Spinal Fusion from T3 to L1. She returned to modeling a few months post-op, and returned to horseback riding at 6 months post-op.
Case Review #7: Progressive Adult Idiopathic Scoliosis with a 75 degree curva...Robert Pashman
The patient, a 19-year-old female, presented with a progressive 75° thoracic scoliosis that had increased 21° over four years and was causing her significant pain. Pre-operative images showed the curvature was rigid. The surgical plan was to perform segmental spinal instrumentation from T3 to L1, posterior spinal fusion from T3 to L2, and spinal osteotomies from T4 to T9 to correct the rigid curvature. Post-operatively, a 43° correction was achieved, reducing the curvature to 27°, and the patient was able to resume her normal activities with no restrictions after one year.
Case Review #B: 20 year old with Adolescent Idiopathic ScoliosisRobert Pashman
20 year old female with a 48° primary thoracolumbar curve with a compensatory 34° thoracic curve. Dr. Pashman treated the patient with a thoracolumbar anterior spinal fusion.
Case Review #24: A 15 Year Old Female with Adolescent Idiopathic ScoliosisRobert Pashman
Dr. Pashman followed the patient for three years. After a growth spurt, her scoliosis curvature progressed significantly, and she required scoliosis surgery.
Case Review #51: 59 year old Female with Collapsing ScoliosisRobert Pashman
A 59 year old female presented to Dr. Pashman with a 60 degree throacic curve, in extreme pain. She failed conservative therapy and opted to have scoliosis surgery.
Case Review #16: 59 year old woman with 25 year history of Adult Idiopathic S...Robert Pashman
59 year old female presented with 25 year history of scoliosis progression. 68° thoracic curve, 42° lumbar curve. Dr. Pashman treated her with a fusion T3-L4. KIM/SRP Classification 1.
Case Review #21: Triple Curvature Adult Idiopathic ScoliosisRobert Pashman
A 23 year old male presented with a triple adult idiopathic scoliosis curvature. The curvature progressed despite bracing. Dr. Pashman performed a spinal fusion from T4-L3.
Case Review #40: 45 year old woman with 75 degree ScoliosisRobert Pashman
1. A 45-year-old female presented with a 75 degree progressive idiopathic scoliosis causing significant back pain and loss of height.
2. Pre-op x-rays showed a 75 degree thoracolumbar curve with coronal and sagittal imbalance.
3. The patient underwent a two-stage surgery including anterior interbody fusion at L4-5 and L5-S1 followed by posterior spinal fusion and instrumentation from T3 to the sacrum to correct the deformity.
Case Review #41: 35 year old female with a 92 degree ScoliosisRobert Pashman
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.
Case Review #17: 20 year old female with Adolescent IdiopathicScoliosis Robert Pashman
A 20 year old female, with Adolescent Idiopathic Scoliosis. She deferred surgery until after college. Dr. Pashman performed a Posterior Spinal Fusion from T3-L1.
Case Review #22: 50 year old female presented with Scoliosis and spondylolis...Robert Pashman
50 year old female presented with Adult Idiopathic Scoliosis and Spondylolisthesis. She suffered from low back pain and leg pain. Dr. Pashman performed a spinal fusion on the patient.
Case Presentation#56: Adult Idiopathic ScoliosisRobert Pashman
A 28 year old female with progressive Adult Idiopathic Scoliosis postponed surgery from age 17 to 28. The patient failed conservative therapy and decided to have surgery due to pain and curve progression.
Case Review #7: 51 year old female with severe flatback after multiple surge...Robert Pashman
A 51 year old female status post multiple spine surgeries presented to Dr. Pashman with severe Flatback Syndrome and psueoarthrosis. Dr. Pashman treated the patient with a Posterior Spinal Fusion T4-Pelvis.
Case Review #53: 58 year old female with Adult Scoliosis and low back painRobert Pashman
A 58 year old female presented with severe, progressive, Lumbar Scoliosis. The patient failed conservative therapy and had unrelenting leg pain. She was treated with a posterior spinal fusion from T11-pelvis.
Case Review #29: 57 year old female with Adult Thorcolumber ScoliosisRobert Pashman
57 year old female with Adult Idiopathic Scoliosis. She presented with a 62 degree thoracolumbar curve. Dr. Pashman treated the patient with a posterior spinal fusion from T10-Pelvis. Dr. Pashman took great care with incision closure to preserve the patient's tattoo. KIM/SRP Classification 2.
Case Review #11: Adult Idiopathic ScoliosisRobert Pashman
A 60 year old male presented with a 50+ degree curvature. He was status post lumbar fusion from L4-S1, and continued to have significant low back pain.
Case Review #47: 20 year old female with Adult Idiopathic ScoliosisRobert Pashman
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.
Case Review #39: 55 year old male with Progressive ScoliosisRobert Pashman
A 55 year old male presented with Progressive Adult Idiopathic Scoliosis. While he was preparing for surgery, he lifted a heavy item, and had neck pain and pain going down his arm. The patient was found to have myeloradiculopathy and spinal cord effacement and required an Anterior Cervical Fusion prior to scoliosis surgery. The following year he had a posterior spinal fusion for Scoliosis.
Case Review #14: 16 year old female with progressive adolescent scoliosisRobert Pashman
A 16-year-old female presented with progressive adolescent idiopathic scoliosis. Her curve had increased from 40 degrees to 46 degrees over two years while wearing a brace. Pre-op x-rays showed a 46 degree thoracic curve. The indications for surgery were a progressive curve, pain, and deformity. The surgical strategy involved segmental spinal instrumentation from T2 to L1 using pedicle screws, multiple osteotomies from T5 to T10 including Smith-Peterson osteotomies, and posterior spinal fusion from T3 to L1. Post-op films showed the patient was well-balanced in the coronal and sagittal planes, and her symptoms resolved following surgery.
Adult Idiopathic Scoliosis is a progressive scoliosis case in a 31-year old female from the Cayman Islands whose curvature progressed after pregnancy and caused thoracic and lower back pain. She presented with a 91 degree curvature from T3 to T12 and in a wheelchair with pulmonary compromise. The surgical strategy involved an anterior release and thoracoplasty, followed by posterior spinal fusion from T3 to L1 using pedicle screws and hooks to correct the curvature. This resulted in a 52% correction of her curvature and resolution of her symptoms.
Case Review #18: 79 year old female with Degenerative scoliosisRobert Pashman
1) A 79-year-old female with adult degenerative scoliosis, herniated discs, and spondylolisthesis underwent spinal fusion surgery.
2) The surgery involved segmental spinal instrumentation from L1 to the pelvis, a pedicle subtraction osteotomy at L3 to create lordosis, and posterior spinal fusion from L1 to the pelvis.
3) Post-operatively, the patient's sagittal balance was normalized, with 5 degrees of lordosis achieved compared to 20 degrees of kyphosis pre-operatively, improving her ability to walk with less pain.
Similar to Case Review #19: Adolescent Idiopathic Scoliosis (20)
Case Review #6: 45 year old woman with flatback syndrome after several surger...Robert Pashman
A 45-year old female with a flat back due to multiple spine surgeries for scoliosis underwent surgery to correct her sagittal imbalance. The surgical strategy included a T10 to sacrum fusion with pedicle subtraction osteotomy at L3 to induce lordosis. Post-operatively, sagittal balance was restored but a slight coronal imbalance remained due to prior fusion in a shifted position. Good functional outcomes are expected with less than 4cm of coronal imbalance.
Case Review #5: 67 year old woman with flatback syndrome following 5 spinal s...Robert Pashman
A 67 year old female presented to Dr. Pashman with severe Flat back Syndrome after 5 previous spine surgeries for Adult Idiopathic Scoliosis. Dr. Pashman treated her with a Posterior Spinal Fusion from T8 to S1.
Case Review #2: 66 year old female with severe Flatback SyndromeRobert Pashman
A 66 year old female presented with severe Flat back Syndrome, Kyphosis, and critical stenosis. Dr. Pashman treated the patient with a posterior spinal fusion T2 to the pelvis. The patient was able to stand up straight following surgery.
Case Review #34: 44 Year Old Woman with Adult Idiopathic ScoliosisRobert Pashman
A 44 year old woman presented with Adult Idiopathic Scoliosis. She wore a brace as a child, and the curvature progressed to the point she required surgery.
Case Review #35: 43 year old female with Adult Scoliosis and a Transitional V...Robert Pashman
1. This case review summarizes the treatment of a 43-year-old female patient with adult scoliosis and a lumbar sacral transitional vertebra.
2. She had a 40 degree lumbar curve and a fused L5-S1 region on the right side.
3. Her treatment plan involved an anterior interbody fusion at L4-5 and L5-S1 followed by posterior segmental spinal instrumentation, spinal osteotomies, and posterior spinal fusion to correct her deformities and relieve her pain.
Case Review #B: Spondylolisthesis Surgery Robert Pashman
A 16-year-old female presented with lower back and left leg pain following a motor vehicle accident. Imaging showed spondylolisthesis at L5 from fractures of the pars interarticularis. She underwent microscopic bilateral L5 laminotomy, foraminotomy, and repair of the L5 pars fractures with bone grafting and instrumentation. Post-operatively, her symptoms resolved and she was able to return to normal activities.
Case Review #2: Isthmic Spondylolisthesis Grade IVRobert Pashman
Case review: A 58 year old female with Isthmic Spondylolisthesis status post surgery. She continued to experience back pain and leg pain, and was treated with spinal surgery.
Case Review #A: Major League Baseball Player has a Spinal FusionRobert Pashman
25 year old Major League Baseball Player presented with low back pain. Upon review of CT scans, he was discovered to have a pars fracture and require surgery,
Case Review #27: 59 Year Old Female with Progressive Adult ScoliosisRobert Pashman
59 year old female presented with Progressive Adult Idiopathic Scoliosis, Spondylolisthesis, Flatback Deformity, and Stenosis. The patient was treated with a spinal fusion,
Case Review #31: 60 Year Old Female with Adult Idiopathic ScoliosisRobert Pashman
60 year old female presented with Adult Idiopathic Scoliosis and Grade 2 Isthmic Spondylolisthesis. She was treated with an anterior and posterior spinal fusion.
Case Review #C: Adolescent Idiopathic ScoliosisRobert Pashman
A 14 year old female presented with Adolescent Idiopathic Scoliosis with a Thoracolumbar Curve. She was treated with an anterior throaco-abdominal approach.
Case Review #19: 40 year old Male with Adult Idiopathic Scoliosis with Flatba...Robert Pashman
A 40 year old male presented after scoliosis surgery at age 14. He presented with Flatback Syndrome and increasing low back pain and required revision surgery.
Case Review #13: 13 year old female softball player with Adolescent Idiopathi...Robert Pashman
A 13 year old female softball player presented with Adolescent Idiopathic Scoliosis. The degree of her scoliosis curve progressed to 48 degrees and she required a spinal fusion.
Case Review #4: Adolescent Idiopathic Scoliosis with 61 degree curvatureRobert Pashman
A 22 year old female presented with Adolescent Idiopathic Scoliosis. She was braced as a child, and the curve continued to progress until she required surgical intervention.
Case Review #28: Patient with Lumbar Scoliosis status post surgery with Harr...Robert Pashman
A 37 year old female presented status post posterior spinal fusion for Adolescent Idiopathic Scoliosis. She had Harrington Rods and the lumbar curve continued to progress, requiring surgical intervention.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Case Review #19: Adolescent Idiopathic Scoliosis
1. Case Review:
17 year old female with
progressive Adolescent
57°
Idiopathic Scoliosis,
followed for six years prior
58° 52° to surgery.
Robert S Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com
2. Patient History
• 18 year old female
• Followed by Dr. Pashman for 5+ years.
• Progressive Adolescent Idiopathic Scoliosis
• Upper back pain
• Lumbar back pain
• Failed conservative therapy
3. Pre-op X-rays
Note the progression
of the curve on these
interval x-rays. The
size and rotation of
both curves suggest
44° 57°
this is a double
major curve, not a
43° thoracic deformity
52°
with a compensatory
lumbar curve.
June, 2008 Feb, 2010
4. Bending X-rays
Bending films suggest both thoracic and lumbar structurality indicating that this
is a double major curve. Right-side bending revealed that L4 could be centered
over the central ala and therefore this was chosen as the distal fusion level.
5. Indications for Surgery
1. Progressive right thoracic Kim SRP2/type 1CN curved
adolescent idiopathic scoliosis.
2. Double major curve with severe rotation thoracic and lumbar
component.
3. Failed conservative therapy with progressive curve, follow time
6 years.
4. Increasing pain upper thoracic low back pain due to progressive
scoliosis.
5. Element of thoracic kyphosis, adolescent idiopathic scoliosis.
6. Surgical Strategy
• Thoracic 4 to lumbar 4 segmental spinal instrumentation with
5.5 stainless steel pedicle screw/rod construct.
• Posterior spinal fusion, thoracic 4 to lumbar 4, with combination
of locally harvested autogenous bone crouton extenders and
rhBMP.
• Multiple level Smith-Petersen osteotomy for duction of flexibility
to rigid thoracic component, T5 to T11, that is a 6-level
osteotomy.
• Intraoperative OR neuro-navigation.
• Intraoperative somatosensory evoked potential and motor
evoked potential interpretation.
• Plastic closure of the wound.
7. Post-op Films
• The patient is well balanced in
the sagittal and coronal planes.
• A 39° thoracic correction was
obtained.
18°
• A 52° lumbar correction was
obtained.
10°
0°