Orthopaedics Department, University Hospital Santa Maria - Centro Hospitalar Lisboa Norte, Avenida Professor Egas Moniz, 1649-035, Lisbon, Portugal.
Eur Spine J. 2020 Dec;29(Suppl 2):133-137. doi: 10.1007/s00586-019-06132-9. Epub 2019 Sep 5.
We present a sternoclavicular dislocation as a non-reported complication after spinal kyphotic deformity surgical correction.
The sternocostal complex seems to have an important role in the pathology of Scheuermann's kyphotic deformity. A role for the sternoclavicular complex has never been reported in association with Scheuermann's disease pathology but could explain anterior sternoclavicular dislocation after spinal kyphotic deformity correction.
A 19-year-old male patient underwent surgery for a 74° thoracic kyphosis associated with a 35° thoracic and a 50° lumbar scoliotic curve. In the early post-operative period, the patient developed pain over the left sternoclavicular joint articulation, with a very obvious lump. An X-ray disclosed an anterior sternoclavicular dislocation. After surgical treatment failed, the dislocation was repaired in a second surgical procedure with a flexion and lengthening osteotomy of the middle third of the clavicle followed by capsular repair reinforced with sternocleidomastoid fascia.
At an 8-year follow-up after his spine procedure and 6 years after his clavicular surgery, the patient had full shoulder range of motion and no joint pain, despite the presence of a new sternoclavicular anterior dislocation.
Sternoclavicular dislocation after spine kyphotic deformity correction is presented for the first time; however, it is not possible to establish a causative association. Additional studies are necessary to delineate the role of the sternoclavicular complex in Scheuermann's disease.
我们报告了一例胸脊柱后凸畸形矫正术后的非报道并发症——胸锁关节脱位。
胸锁关节复合体在Scheuermann 后凸畸形的病理中似乎具有重要作用。尚未有文献报道胸锁关节复合体与 Scheuermann 病的病理有关，但可以解释脊柱后凸畸形矫正后前胸锁关节脱位。
一名 19 岁男性患者因 74°胸脊柱后凸伴 35°胸脊柱和 50°腰脊柱侧凸而接受手术。术后早期，患者出现左胸锁关节处疼痛，有明显肿块。X 线显示前胸锁关节脱位。在手术治疗失败后，采用锁骨中段弯曲和延长截骨术，并修复关节囊，同时使用胸锁乳突肌筋膜加强，进行了第二次手术修复。
脊柱手术后 8 年，锁骨手术后 6 年，患者的肩关节活动度完全正常，没有关节疼痛，尽管存在新的胸锁关节前脱位。
首次提出脊柱后凸畸形矫正术后胸锁关节脱位；然而，目前尚不能确定其因果关系。需要进一步研究以明确胸锁关节复合体在 Scheuermann 病中的作用。
