← Back Anonymous | Adolescent Idiopathic Scoliosis
This 13-year-old girl had been diagnosed with scoliosis as a 12-year-old. She had been referred to Dr. Vitale’s clinic by her primary care physician. She had a major curve of 40 degrees. There was no family or past medical history, and she was a competitive diver.
Upon physical exam: fluid, symmetric, age-appropriate gait. Hips heights were equal. Left shoulder was higher than right. There was a right thoracic paraspinal prominence on Adams forward bend test and normal kyphosis. She was able to toe walk and hop on one foot without difficulty.
AP radiographs showed curves of 26, 40 and 20 degrees with an AIS curve pattern. Full-time brace and Schroth physical therapy were recommended in 2022.
A poor brace compliance was observed: 8/18 hours.
- Left upper thoracic C7-T5 27 degrees (out of brace 26 deg for a 0% correction)
- Right thoracic: T5-T11 degrees (out of brace 40 deg for 37% correction)
- Left lumbar: T11-L4 13 degrees (out of grace 20 deg for 35% correction)
Case progressed to surgery:
AP standing, AP supine & AP bending radiographs:
- Thoracic: T1-T5 31 degrees that is 20 degrees in supine and bends down to 15 degrees -> structural proximal thoracic curve
- Left lumbar: T11-L4 35 degrees that is 19 degrees in supine and bends down to 2 degrees -> nonstructural thoracolumbar curve
- Left upper right thoracic: T5-T11 46 degrees that is 30 degrees in supine and bends down to 15 degrees-> nonstructural thoracolumbar curve —MAJOR CURVE
- Instrumentation: UNID COCR ROD 6.0MM, Biomet Vitality 5.5/6.0
- Posterior fusion from T3-L12 with posterior column osteotomies at T6-7, T7-8, T8-9, T9-10.
- No intraoperative complications or changes in neuromonitoring
Post operation: it was an uneventful recovery, and the patient is doing well.