Physical examination confirms a healthy girl in all respects. She has just had her menarche. Neurologic exam is normal. The back shows a right thoracic curve with a small rib hump. Plumb line drops 1.5 cm to the right.
Anteriorly one can notice the rotation of the left ribs.
Posterior instrumentation and fusion Case Management Anterior discectomy and fusion is ideal for this patient. The endoscopic approach for discectomy, correction, and fusion, while in its infancy, has much to offer. This patient underwent such a procedure. One lung ventilation was obtained with a double lumen endotracheal tube. The patient was turned onto her side with right side up.