A 31 year old woman, with Adult Idiopathic Scoliosis, 75° stiff lumbar curve, rotated 90°. Dr. Pashman treated the patient with and Anterior Spinal Fusion followed by a Posterior Spinal Fusion. KIM/SRP Classification 2.

1. Adult Idiopathic Scoliosis with
Lumbosacral Kyphosis:
Treated with Anterior and Posterior
Spinal Fusion
Robert S. Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com

2. Patient History
• 31 Year old female
• Diagnosis: Progressive Adult Idiopathic Scoliosis
with Lumbosacral Kyphosis
• Patient diagnosed at age 12, did not wear her brace
• Four inch height loss
• Low back pain, leg pain
• Failed to respond to conservative therapy

3. Pre-Operative
X-Rays
• 75° curvature of the
lumbar spine, rotated
approximately 90°
• 2 cm decompensation
75°

4. L R
Bending X-rays: The patient has a very stiff lumbar obliquity that
does not correct on right or left side bending.

5. Surgical Strategy
• Radical discectomy of T10-L1
(7 levels)
• Anterior interbody fusion L4-S1,
using PEAK and autogenous rib
bone graft
T10
• Anterior interbody fusion T10-L4
L1
using morselized bone graft
L4
• Posterior Spinal Fusion T10 to
S1 Sacral Pelvis
Pelvis

6. Results
The original surgical plan
was to fuse T10 to S1.
Spinal balance was
achieved by T12, therefore
two levels were spared.

7. Pre-Op/
Post-op
Comparison
A correction of 57%
was obtained. The
lumbar kyphosis has
been corrected in the
75° 32° frontal plain.

8. Thoracic kyphosis
corrected. The pre-
operative pain that
she was experiencing
in her back and legs
has significantly
decreased, and she
requires minimal pain
medication. The
patient is quite
pleased with her
appearance.