A 17 year old female consulted with Dr. Pashman for a second opinion on scoliosis surgery. The patient presented with a 50 degree curve despite wearing her brace as instructed. She had a posterior spinal fusion.

1. Case Review:
17 year old female with
50° Adolescent Idiopathic Scoliosis
Curve progression despite bracing
Robert S Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com

2. Patient History
• 16+9 year old female
• Adolescent Idiopathic Scoliosis
• Patient wore her brace with good compliance for 2 years
• Curve progression despite bracing
• 2-cm right rib hump and elevation of left shoulder

3. Pre-op X-rays and
Indications for Surgery
1. Lenke 1A 50 degree of
progressive adolescent idiopathic
scoliosis.
2. Failed conservative therapy,
50°
including bracing.
3. Now with increasing curve and
upper thoracic pain.

4. Surgical Strategy
• T3 to L1 selective thoracic fusion for Lenke 1C progressive
adolescent idiopathic scoliosis using quarter-inch stainless steel
Legacy pedicle screw rod construct.
• Multiple level spinal osteotomy at T4 to T10, Smith-Pete
osteotomies, radical facetectomies.
• Posterior spinal fusion, T3 to L1, using locally harvested
autogenous bone and banked allograft.
• Intraoperative SSEPs and motor-evoked potentials.
• Intraoperative O-arm neuro navigation.

5. Pre-Op/Post-op Comparison
50°