Surgical Sagittal Correction of Symptomatic Sweeping Thoracolumbar Lordosis in an Adolescent With Congenital Kyphoscoliosis.

A healthy 15-year-old male athlete presented with upper thoracic congenital kyphoscoliosis, causing notable pain and limiting participation in competitive sports. In addition to mid and low back pain related to sagittal profile, the patient also expressed concerns regarding shape of his back from the compensatory thoracolumbar lordosis relative to his desired physical activities. Imaging demonstrated an abnormal fusion segment from T4-T8 with hemivertebrae at T6 and T7. After failing conservative management, the patient underwent T2-L2 posterior spinal fusion with posterior column osteotomies, successfully restoring sagittal alignment and allowing a return to high-impact sports. Unfavorable symptoms associated with abnormal sagittal spinal alignment should be considered even in a stable, nonprogressive deformity. Sagittal correction with posterior spinal instrumented fusion can effectively restore sagittal posture and function in athletes with congenital kyphoscoliosis associated with a sweeping and symptomatic thoracolumbar lordosis, altering the natural history of the deformity and improving quality of life.