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Ms, A, a 10 year old bubbly girl is one of the twins born prematurely.When she was about 3 years old,her mother noticed that her back was bent to the left.They visited various hospitals sporadically and when the deformity was quiet evident,she presented to us at the age of 7 years. She was diagnosed to have an Early Onset Scoliosis.

It was a left thoracic curve from T5 to T12 measuring 55 degrees.MRI showed no spinal card anomaly. It required surgical corrections. However instrumentation and fusion at the age of 7 years would stunt the growth of her lungs and hence she was treated with Growth Rods with anchors T4 & 5 and T12 & L1(Synthes USS ll System). aThe rods were distracted once in 6 months maintaining correction and allowing development of lungs. She underwent 3 more such distractions after the index surgery at 6 monthly intervals.

 

Now she is close to 10 years old.She has attained a precocious menarche.Her Scoliotic curve is extending into the upper lumbar spine.Now that the lung growth is nearly complete it is time for a final intsrumented correction  and fusion.The cobb angle of her thoracolumbar curve measured 60 degrees.Instrumentation with pedicle screws from T4 to L3 was planned based on her standing Ap,standing Lateral & Supine Bending views.At surgery,the thoracic segment from T4 to T11 was found to be completely fused.Pedicle screws were placed in the thoracic and lumbar spine as seen in the prt-op images.Correction was achieved by rod rotation on the convex side at the Thoracolumbar junction and 6mm contoured rods were placed on either side sequentially(DePuy Synthes USSLL & UDS Systems were used).Costoplasty was performed to reduce the rib-hump.The excised ribs were used for the fusion.

She has good sagittal & coronal balance post-op and has no neurological deficit.She is walking independently and has been discharged on the 5th Post-op day in stable condition.the girl as well as her parents are happy with the cosmetic correction achieved.

 

Wednesday, 24 February 2016 15:49
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