Posterior Spinal Fusion and Instrumentation for Adolescent Idiopathic Scoliosis

Description

This video transcription features Roger Widmann, Chief of Pediatric Orthopedics at the Hospital for Special Surgery, providing a detailed account of a surgical procedure for adolescent scoliosis. He explains that surgery is considered for adolescent patients whose spinal curvature exceeds 50 degrees, which can lead to physical imbalances and back pain due to degenerative changes.



The case presented involves a 15-year-old female patient who initially had a 35-degree curve diagnosed at age 12. Despite two years of bracing, her condition worsened, necessitating surgery after comprehensive risk discussions with her family. Radiographic examinations prior to surgery indicated significant curvature in the thoracic spine at 58 degrees, alongside a flexible lumbar curve.



The surgical process is thoroughly outlined, starting with the patient's position and incision to access the thoracic spine. Various techniques are applied to expose and prepare the spine for fusion, including the use of electric cautery and intraoperative x-ray verification. The surgeon describes the meticulous steps involved in exposing the vertebrae, preparing bone grafts, and installing pedicle screws.



Dereeling continues with rod placements that help correct the deformity and ensuring anatomical accuracy through live x-rays. Techniques of de-rotation and correction of the spine deformity are elaborated upon, followed by final adjustments and confirmations of the surgical success, which reveal significant correction of the curvatures without the need for lumbar fusion. The result is assessed with post-operative X-rays, showing excellent outcomes in restoring the patient's spinal alignment.

Specialties