漏斗胸Nuss手术后获得性脊柱侧弯：一例报告。
Acquired scoliosis following Nuss procedure for pectus excavatum: A case report.
作者信息
Meng Yichen, Lin Tao, Shao Wei, Gao Rui, Zhou Xuhui
机构信息
Department of Orthopedics, Shanghai Changzheng Hospital, Second Military Medical University, No. 415 Fengyang Road, Shanghai, People's Republic of China.
出版信息
Medicine (Baltimore). 2019 Jan;98(1):e13855. doi: 10.1097/MD.0000000000013855.
RATIONALE
Nuss procedure is a safe and popular minimally invasive surgical technique for the correction of pectus excavatum in adolescents. Acquired scoliosis over 50 degrees after Nuss procedure has never been reported.
PATIENT CONCERNS
A 14-year-old boy was referred to pediatric surgery for pectus excavatum deformity. He underwent a successful Nuss procedure. At follow up, the patient was noted having an asymmetric back whole spine X-ray showed a right-sided thoracic curve with a Cobb angle of 54 degrees.
INTERVENTIONS AND OUTCOMES
We obtained a satisfactory result by removing the pectus bar and prescribing the patient a brace.
LESSONS
This report demonstrates that the spine should be evaluated routinely before and after Nuss procedure. Besides, spinal fusion is not recommended for acquired scoliosis following pectus excavatum surgery.
理论依据
努斯手术是一种用于矫正青少年漏斗胸的安全且常用的微创手术技术。努斯手术后获得性脊柱侧弯超过50度的情况此前从未有过报道。
患者情况
一名14岁男孩因漏斗胸畸形被转诊至小儿外科。他接受了成功的努斯手术。在随访中，发现患者背部不对称，全脊柱X线显示右侧胸弯，Cobb角为54度。
干预措施及结果
我们通过取出鸡胸矫正棒并为患者开具支具，取得了满意的效果。
经验教训
本报告表明，在努斯手术前后应常规评估脊柱。此外，不建议对漏斗胸手术后获得性脊柱侧弯进行脊柱融合术。
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