Female, 6 years old, with scoliosis 5 years, had operated for 6 months, without family history of disease, without trauma and fractures history.

Physical Examination

The patient can walk normally, with low posterior hairline£¬ both shoulder have equal height, the spine C-shaped with lordosis and kyphosis, the thoracic vertebra convex to lift and behind. There is a 4cm distance between the vertical line through 11th thoracic and sacrum center when stand upright. The distance between both rib cage and iliac crest is 10cm. Risser index is 0. both lower extremities have equal length, and nervous system is normal with normal sensory, musclar strength, normal reflex, and negative pathological refleexes in bilateral lower estremities.

Further X-ray Examination£º

Preoperative Cobb Angle :120 degree,

Postop Cobb Angle: 60 degree,

Postop 2months Cobb Angle:75 degree,

Postop 3.5 months Cobb Angle: 84 degree, the top claw had amotiod with 3rd thoracic vertebral plate fracture.

Diagnosis: idiopathic scoliosis.

Purpose for discussion: What can we do for this girl now? Should or not unload the internal fixation?

Preoperative AP view of full length standing x-ray of spine

Preoperative lateral view of full length standing x-ray of spine

Postoperative AP view of full length standing x-ray of spine

Postoperative lateral view of full length standing x-ray of spine

Postoperative AP view of full length standing x-ray of spine at 2 months follow-up

Postoperative lateral view of full length standing x-ray of spine at 2 months follow-up

Postoperative AP view of full length standing x-ray of spine at 3.5 months follow-up

Postoperative lateral view of full length standing x-ray of spine at 3.5 months follow-up