E-Case report
Adult Degenerative Scoliosis
T4 – Ilium – S2 Alar-IliacPawel P. Jankowski, MD
![intro-pawel](https://neo-medical.com/wp-content/uploads/2022/03/intro-pawel.jpg)
Pre OP
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
Clinical Case – Adult Degenerative Scoliosis
T4 – Ilium – S2 Alar-Iliac
Pawel P. Jankowski, MD
Neurosurgeon
Hoag Hospital
Newport Beach, CA
USA
![logo-hoag](https://neo-medical.com/wp-content/uploads/2022/03/logo-hoag.jpg)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![Pawel P Jankowski](https://neo-medical.com/wp-content/uploads/2022/03/Pawel-P-Jankowski.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Patient Information
73-year-old female patient, Adult Degenerative Scoliosis.
Mixed bone quality with very soft bone in the lower lumbar/sacrum region, and sclerotic hard bone in the thoracic spine.
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
![pre-op-1](https://neo-medical.com/wp-content/uploads/2022/03/pre-op-1.png)
Pre OP radiographs
frontal and sagittal views
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Intra OP
![ligne](https://neo-medical.com/wp-content/uploads/2021/02/ligne-e1613577992934.png)
The surgery was planned for correction and stabilization, posterior construct: S2AI – Iliac – S1 and up to T4
with the Neo Pedicle Screw System™.
A pedicle subtraction osteotomy (PSO) in the mid/lower lumbar area.
![intra-op-1](https://neo-medical.com/wp-content/uploads/2022/03/intra-op-1-e1646397429180.jpg)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b.png)
![Vector](https://neo-medical.com/wp-content/uploads/2021/01/Vector-3.png)
![Rectangle-13](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-13.png)
![intra-op-2](https://neo-medical.com/wp-content/uploads/2022/03/intra-op-2.jpg)
![Rectangle-11](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-11.png)
Neo Pedicle Screw System™ was used for the long construct including dual rods.
4 x Iliac screws Ø8.0 x 80mm in S2AI, Iliac
2 x Ø7.0 x 45mm in S1
A majority of pedicle screws in the thoraco-lumbar regions were Ø7.0 x 45/50mm, and Ø6.0 x 45/50mm,and a few Ø5.0 x 45/35mm screws were implanted.
2 x 500mm titanium rods, and dual rods were 160mm titanium.
![Rectangle-15](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-15.png)
Rod fit & contouring
![intra-op-3](https://neo-medical.com/wp-content/uploads/2022/03/intra-op-3.png)
![ligne-2b-1-reverse](https://neo-medical.com/wp-content/uploads/2022/01/ligne-2b-1-reverse.png)
![Rectangle-14](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-14.png)
Sublaminar band, Jazz™ Lock System band (Implanet) used in cranial level T2/3. All set screws have been placed. Thanks to the Neo convex set screw technology, self-alignment of the guide towers.
Final tightening of the set screws.
![intra-op-4](https://neo-medical.com/wp-content/uploads/2022/03/intra-op-4.png)
![Rectangle-10](https://neo-medical.com/wp-content/uploads/2021/01/Rectangle-10.png)
Post OP
Post OP radiographs, frontal and sagittal views
![post-op-1](https://neo-medical.com/wp-content/uploads/2022/03/post-op-1.png)
![ligne-2b](https://neo-medical.com/wp-content/uploads/2021/01/ligne-2b-1.png)
![follow-up](https://neo-medical.com/wp-content/uploads/2022/04/follow-up.png)
Follow Up at 1 month
Post OP
Standing radiographs at 1 month postoperatively, frontal and sagittal views
![ligne-2b-1-reverse](https://neo-medical.com/wp-content/uploads/2022/01/ligne-2b-1-reverse.png)
Published with the approval of Dr. Pawel P. Jankowski, MD