Abstract
BACKGROUND: Harrington rod instrumentation used to treat idiopathic scoliosis wasn't able to correct the sagittal balance or the rotation of the vertebrae and can lead to secondary problems below the achieved fusion. CASE DESCRIPTION: We present a patient who presented to the Department of Orthopaedics and Traumatology in Infant Jesus Clinical Hospital with worsening symptoms of back pain and numbness radiating to the left lower extremity and claudication. The patient was previously treated with Harrington rod for adolescent idiopathic scoliosis. X-rays showed progression in the spinal deformity with a thoracolumbar curvature of 54° Cobb's angle and significant vertebral rotation. She was diagnosed with type 2 adult scoliosis and qualified for surgery. She underwent a Th9-L4 posterior instrumented spinal fusion with correction and derotation; however, the first follow-up 3 months post-surgery revealed dislodgement of the instrumentation. Therefore, revision surgery had to be performed to replace the loose pedicle screws. At follow-up, the patient showed significant improvement with Cobb's angle decreased to 42°, decreased pain with no radiation and improved gait and movement. CONCLUSIONS: The presented case report indicates that patients with fusion and secondary changes after unilateral instrumentation should receive surgery as soon as they meet the criteria, as it can greatly improve their symptoms and quality of life.