Recently, a very cute short haired girl came over, brought by her mother. She has a left chest curved posture, and the photo shows an atypical left chest waist combined curvature. Occasionally, there is still a large C-bend, but what is puzzling is that she has a scoliosis to the left, while in the FBT experiment, the top vertebra protrudes to the right.

Left translation of trunk, X-ray shows left major C-bend

The child's FBT experiment showed a lateral curvature with the top vertebra rotating to the right

Generally, when bending on the right side, the top vertebra will rotate to the right; Left curvature, lumbar curvature, and rotation of the top vertebra to the left, without exception, are the results of a certain degree of tethering effect on the posterior structure of the spine after scoliosis.

Generally, when bending on the right side, the top vertebra will rotate to the right; Left curvature, lumbar curvature, top vertebra rotates to the left without exception

However, it is very rare for her to have a left-sided curvature with the top vertebra rotating to the right, indicating that the tethered area of her lateral curvature is different from that of a regular lateral curvature, and it is likely to be a anterior structural tethered area. This is similar to the results of Professor PETER NEWTON's recent anterior tethering surgery at San Diego Children's Hospital in the United States: if there is excessive growth potential after non fusion surgery with anterior tethering of the spine, after correcting the scoliosis, it may cause the scoliosis to bend towards the opposite side.

Figure A is a preoperative photo showing a right chest curvature; Figure B shows the image after non fusion surgery with anterior tethering, and the effect is satisfactory; Figure C shows the curvature of the spine to the left as the patient grows 2 years later，

但此种左侧弯曲一般顶椎旋转还是向右侧

但我们的这位小姑娘为什么会出现前方栓系呢？仔细阅片后发现，她的心包和胃壁轮廓有明显的波浪状改变，这和正常轮廓并不一致，怀疑结缔组织异常。和妈妈深入沟通后，决定还是先去风湿免疫科做进一步检查。虽然我希望能够通过保守治疗让所有轻度脊柱侧弯的孩子都得到好转，但是明确自己能力的边界非常重要。这对于信任我的孩子和孩子妈妈，是另一种负责。