Popescu David, Merhi David Abou, Amellal Omar
Department of Orthopedic Surgery, Cliniques Universitaires de Saint Luc, Bruxelles, Belgium.
J Orthop Case Rep. 2024 Jan;14(1):125-130. doi: 10.13107/jocr.2024.v14.i01.4172.
This case report abstract discusses scoliosis, a multifactorial three-dimensional spinal deformity, including lateral curvatures on the frontal plane characterized by Cobb angle measurement, vertebral rotation on the axial plane and sagittal deformity. Scoliosis can be mild, moderate, or severe, and if left untreated, it can lead to further deformity and compromise cardiopulmonary function. Scoliosis is classified into early onset and late onset, with idiopathic scoliosis being the most common form. Early-onset scoliosis has various etiologies, including idiopathic, congenital, neuromuscular, and syndromic. Early management is crucial to minimize complications, such as restrictive ventilatory disorder and pulmonary dysplasia. This case report focuses on an iatrogenic cause of scoliosis due to rib synostosis, which is not included in the classification. Treatment options include non-operative management and surgical interventions, with the use of vertical expandable prosthetic titanium rib (VEPTR) thoracoplasty to correct the spinal deformity.
This article illustrates the case of a 13-year-old girl who developed a left thoracic scoliosis caused by ribs fusion, following multiple right thoracotomies during childhood for esophageal atresia with tracheoesophageal fistula. No vertebral abnormalities were reported. Considering the young age of the girl, spinal fusion was not considered. A VEPTR associated with an excision of the fused ribs was used to treat this patient.
The aim of this article was to illustrate the importance of a regular follow-up for the patients who have undergone multiples thoracotomies during their childhood even without vertebral abnormalities and propose an early approach to avoid spinal fusion in early adulthood.
本病例报告摘要讨论了脊柱侧弯,这是一种多因素导致的三维脊柱畸形,包括额状面上以Cobb角测量为特征的侧凸、轴面上的椎体旋转以及矢状面畸形。脊柱侧弯可分为轻度、中度或重度,若不治疗,可能导致进一步畸形并损害心肺功能。脊柱侧弯分为早发性和晚发性,特发性脊柱侧弯是最常见的类型。早发性脊柱侧弯有多种病因,包括特发性、先天性、神经肌肉性和综合征性。早期管理对于将诸如限制性通气障碍和肺发育不良等并发症降至最低至关重要。本病例报告聚焦于由于肋骨融合导致的医源性脊柱侧弯病因,该病因未包含在分类中。治疗选择包括非手术管理和手术干预,使用垂直可扩张人工钛肋骨(VEPTR)胸廓成形术来纠正脊柱畸形。
本文阐述了一名13岁女孩的病例,该女孩童年期因食管闭锁合并气管食管瘘接受多次右胸廓切开术后,出现了由肋骨融合导致的左胸段脊柱侧弯。未报告椎体异常情况。考虑到女孩年龄较小,未考虑进行脊柱融合术。使用与切除融合肋骨相关联的VEPTR来治疗该患者。
本文的目的是说明对于童年期接受多次胸廓切开术的患者,即使没有椎体异常,定期随访的重要性,并提出一种早期方法以避免成年早期进行脊柱融合术。