Adult Idiopathic Scoliosis

Robert S. Pashman, MD

Director of Scoliosis and Spinal DeformityCedars-Sinai Institute for Spinal Disorders

Adult Idiopathic Scoliosis

• 31 Year old female from Cayman Islands• Diagnosis: progressive scoliosis with a 4cm

right rib hump• Curvature progressed status post pregnancy• Thoracic and lower back pain; failed to

respond to conservative therapy• Patient presented in a wheelchair, with

pulmonary compromise

Pre-Operative X-Rays

Surgical Strategy

• Right thoracotomy with anterior release and thoracoplasty

• Segmental spinal instrumentation using pedicle screw rod-hook construct from T3 to L1 (12 levels)

• Posterior Spinal Fusion T3-L1• Multiple level concave osteotomy• Correction of fixed adolescent

idiopathic scoliosis curvature of 91 degrees T3 - T12

Results

• The patient’s symptoms were resolved, and she was pleased with the cosmetic outcome.

Pre-Op Post-op

ComparisonAlthough the patients thoracic curve was very stiff, a correction of 52% was obtained.