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Clinical details. 14 years / Girl Deformity noticed 3 months back Right shoulder up Menarchy – 6 months Risers stage – 0 Crossed Peak height velocity Abdominal reflex – B/L symmetrical Neurology - Normal. Radiography. Right sided convexity Right shoulder up Double thoracic curve
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Clinical details • 14 years / Girl • Deformity noticed 3 months back • Right shoulder up • Menarchy – 6 months • Risers stage – 0 • Crossed Peak height velocity • Abdominal reflex – B/L symmetrical • Neurology - Normal
Radiography • Right sided convexity • Right shoulder up • Double thoracic curve • Main thoracic • Apex – D 9 • UEV – D 6 • LEV – D 12 • Cobb – 55 degrees correctible to 30 degrees • Proximal thoracic • Apex – D ¾ disc • UEV – D1 • LEV – D 6 • Cobb – 30 degrees – Rigid • Stable vertebra – L 1 • Lumbar Modifier – A • Sagittal modifier - N
Lenke • Double Thoracic – Type II • Lumbar modifier – A • Sagittal modifier – N II A N
Strategic vertebra • D 1 – UVE of PT • D ¾ - Apex of PT • D 6 – LEV of PT / UEV of MT • D 9 – Apex of MT • D 12 – LEV of MT • L 1 – Stable • D 12 / L 1 disc is mobile • D 1 is Junctional
Instrumentation Vertebrae • D 2 • D 4 • D 6 • D 9 • D 12
1 6 9 12 5
1 6 9 12 1 5
6 9 12 1 5
2 6 9 12 1 5
1 6 9 12 5