pedicle screws

Observation

Curves < 20^o observation only at 3-6 month intervals depending on growth rate 

Non Operative Management / Bracing 

Never brace curves if patient Risser 4 or 5 

Indications

1.  Risser 0-2 (growth potential)

2.  Curve >30^o adolescent

3.  Curve >25^o with progression (5^o in six months)

PLIF / Posterior Lumbar Interbody Fusion

Technique

1.  Wide laminotomy 

- resection flavum, significant cranial lamina

- preserve if possible the posterior elements