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.





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.


   


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.)





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.