AIS: Patient Doing Great and Still Flexible 19 Years after Surgery

Description

As a 15-year-old in 1985, this patient was diagnosed with adolescent idiopathic scoliosis (AIS). She had a 54º curve in her thoracic spine and a 38º curve in her lumbar spine.

Treatment

Dr. Bridwell performed a posterior spinal fusion to correct the thoracic curve. He used segmental spinal instrumentation to treat the thoracic curve and fuse that part of the spine. The fixation was secure enough that no brace or cast was necessary. Dr. Bridwell has been fixing idiopathic scoliosis since the mid 1980s with segment spinal instrumentation such that these patients do not require any bracing postoperatively.

Many surgeons would have fixed both curves and fused her spine from the thoracic spine to the lumbar spine. However, Dr. Bridwell has always preferred to try to avoid a fusion that long, and, if possible, to just selectively fix one of the curves.

That is what he did in this case—he just fixed the thoracic curve. Fixing the thoracic curve had a stabilizing effect on the lumbar curve; it did not get worse following the surgery. This selective fusion allowed the patient to maintain a flexible lumbar spine.

Result

Twenty-three years after surgery, she still has a very mobile, flexible spine. She is also easily able to bend over and touch the floor, even though she has had a scoliosis fusion.

Note on the Post-op Comparison questionnaire scores that for the pain, function, and mental health questions, the maximum score is 25; for the self-image question, the maximum score is 30; and for the satisfaction question, the maximum score is 10. For the SRS Scores Converted to 100-point Scale, 100 means no pathology.