Surgical Discussion

Patient positioning:  The patient was positioned prone on a Jackson table, ensuring neutral alignment of the head, spine, and pelvis. Care was taken to support pressure points and maintain physiological curves of the spine.

Anatomical surgical approach:  The surgical approach entailed a midline incision over the determined spinal levels. Subperiosteal dissection exposed the laminae, facets, and transverse processes. Multiple Ponte osteotomies were performed at predetermined levels to improve spinal flexibility and facilitate correction. Pedicle screws were inserted bilaterally along the fusion levels, followed by rod placement and curve correction through derotation and translation maneuvers.

Intraoperatively, attention was paid to achieving maximal curve correction while preserving cord integrity, monitored through intraoperative neuromonitoring. The rigidity of the neuromuscular scoliosis posed challenges in mobilization; however, the multiple Ponte osteotomies allowed for significant flexibility enhancement. The fusion extended from the upper thoracic region to the sacrum to ensure comprehensive stabilization and prevent curve progression.

Postoperative protocol:   Not Specified

Follow up:   At 3 months postoperative follow-up, the patient demonstrated improvement in posture and balance, with a gain of 10 cm in height. The surgical intervention halted curve progression and alleviated pulmonary load, contributing to an enhanced quality of life.

Orthopaedic implants used:   Originally posted on LinkedIn by Amr Elshewail