Pujol Oriol, Moreira Felipe, Balcells Joan, Nuño Rosario, Moreno Antonio, Pellise Ferran
Spinal Surgery Unit, Orthopedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Pediatric Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Spine Deform. 2023 Mar;11(2):507-511. doi: 10.1007/s43390-022-00588-4. Epub 2022 Sep 19.
A 13-year-old female with congenital diaphragmatic hernia-associated pulmonary hypertension presented with severe and rapidly progressing scoliosis. The patient suffered from chronic respiratory failure and high risk of hypertensive crisis with potentially life-threating consequences. The scoliosis was treated with a multidisciplinary approach combining preoperative halo-gravity traction, venoarterial extracorporeal membrane oxygenation support and posterior spinal instrumented fusion. After 2 years of follow-up, results are excellent.
The treatment combination reported here for the first time aims to limit surgical aggressiveness. It could be an effective and safe approach for treating severe spinal deformities in very fragile patients with high surgical risk.
一名13岁患有先天性膈疝相关肺动脉高压的女性患者出现严重且迅速进展的脊柱侧弯。该患者患有慢性呼吸衰竭，并有高血压危象的高风险，可能会导致危及生命的后果。采用多学科方法治疗脊柱侧弯，包括术前头环重力牵引、静脉-动脉体外膜肺氧合支持和后路脊柱器械融合术。经过2年的随访，结果良好。
本文首次报道的治疗组合旨在降低手术的侵袭性。对于手术风险高的非常脆弱的患者，这可能是一种有效且安全的治疗严重脊柱畸形的方法。
