Scoliosis: Case Study 01

Standing radiograph (Image A) of a 12 year old girl with idiopathic scoliosis. Her thoracic curve measures 49 degrees from T6 to T11. Her lumbar curve measures 22 degrees from T11 to L3. She is skeletally immature – her Risser sign is 0.

Scoliosis cs A
Scoliosis cs A

Her left bending film (Image B) reveals that the lumbar curve is very flexible and corrects to 0 degrees. Her right bending film (Image C) shows that the thoracic curve is less flexible, correcting to only 25 degrees.

Scoliosis cs B
Scoliosis cs B
Scoliosis cs C
Scoliosis cs C

The goal is to fuse and instrument the spine from the top stable and neutral vertebra to the bottom one. The blue vertebra are the stable/neutral ones (stable means falling on the plumb line, and neutral means having no rotation.)

scoli_cs_diagram

AP (Image D) and lateral (Image E) radiographs show the spine being fused between the stable/neutral vertebra. Note that the curve is not fully corrected, but the spinal alignment is normal.

Scoliosis cs D
Scoliosis cs D
Scoliosis cs E
Scoliosis cs E