AIS: Posterior Approach with a Short Fusion to Correct a Thoracolumbar Curve

Description

When this 14-year-old patient came to Dr. Bridwell, he said that she had adolescent idiopathic scoliosis (AIS) with a right thoracolumbar curve. The curve was 53º. In most cases, curves are more flexible in teenagers than in adults.

Treatment

Dr. Bridwell had a choice: he could fix the curve with an anterior approach (from the front of the body) or with a posterior approach (from the back of the body).

For most thoracolumbar and lumbar curves, he prefers to do an anterior approach because it generally allows for more correction. The anterior approach also allows him to fuse fewer segments of the spine.

However, in this case, Dr. Bridwell determined that a posterior approach would be better. Therefore, he did a posterior spinal fusion with instrumentation. He used pedicle screws in the spine, and then he attached rods to the pedicle screws. The screws and rods held and stabilized the spine while the bones healed and fused. This was a very short fusion.

Result

Three years after surgery, the patient’s curve was reduced to 27º. That is a significant improvement, and this case demonstrates that even with a posterior surgery on a thoracolumbar curve, Dr. Bridwell can get a good result.

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.