Most scoliosis curves in adults do not need surgery, but the ones that do are often driven by accumulated degenerative or traumatic changes. This is a 50 yr old with a Lenke 5 curve stable for many years. He sustained a burst fracture right at the L2 apex and had coronal and sagittal decompensation.
A VCR at L2 and interbody at L4-5 targeting the laterolisthesthesis got the job done. What was invaluable was preoperative planning, especially for the sagittal plane. Having a pre-printed rod by Medicrea/Unid as a template really helped prevent overcorrection at the level of the VCR.
Also nice is using a massive banana TLIF cage to fill the corpectomy, especially in collapsed fractures - NuVasive's Modulus TLIF-A has a huge footprint, almost a mini XLIF interbody...
