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T2 to S1 Fusion for Severe Adult Scoliosis Using Free Hand Technique

Severe Adult Scoliosis

•60 year old woman with progressive height loss and severe low back and leg pain with incapacitation

•Tried multiple conservative measures without benefit

Preop X rays

C10-I2

Preop Lateral X rays

C10-I3

Postop Lumbar X rays

C10-I5

Surgery

•Approximately 10 hours surgery in one setting

•All the screws inserted freehand without using C arm or X rays

•Postop CT showed excellent position of all the screws used

•Less than 800cc blood loss due to good BP control and usage of Tranexamic Acid

Final Follow-up at 18 months

•Excellent outcome

•Patient is pain free and back to work

•Gained about 3 inches in height

•No hardware loosening with solid fusion