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先天性椎体异常儿童严重脊柱后凸畸形的创新麻醉方法:一例报告

Innovative anaesthetic approaches to severe Kyphoscoliosis in a child with congenital vertebral abnormalities: a case report.

作者信息

Chaudhary Rahul Kumar, Bista Prajwal, Gowda Byre

机构信息

Department of Anesthesiology and Critical Care, Birat Medical College Teaching Hospital, Biratnagar, Morang, 56613, Koshi, Nepal.

Department of Anaesthesiology and Critical Care, Postgraduate Institute of Medical Education and Research, Chandigarh 160002, India.

出版信息

Oxf Med Case Reports. 2025 Jun 27;2025(6):omaf081. doi: 10.1093/omcr/omaf081. eCollection 2025 Jun.

DOI:10.1093/omcr/omaf081
PMID:40585447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12202294/
Abstract

The management of severe kyphoscoliosis in children, particularly those with congenital vertebral anomalies, presents a formidable challenge that requires a highly coordinated, multidisciplinary approach. In this case report, we delve into the complex journey of an 11-year-old female diagnosed with extreme kyphoscoliosis (Cobb's angle 90°) complicated by rib and vertebral dysplasia. This unique presentation not only demanded precision in surgical technique but also necessitated advanced anesthetic strategies and real-time intraoperative monitoring to ensure a successful outcome. Undergoing a major spinal deformity correction and stabilization procedure, the patient benefitted from cutting-edge technologies and tailored anesthetic interventions, designed to mitigate the inherent risks of such intricate surgeries. Remarkably, her perioperative course remained entirely uneventful, and she emerged from surgery with exceptional clinical results. This case underscores the importance of a holistic, collaborative care model-where orthopedic surgeons, anesthesiologists, and specialized support teams work in concert to navigate the complexities of congenital spinal anomalies. Key Clinical Message The management of severe kyphoscoliosis in pediatric patients with congenital vertebral anomalies requires a highly coordinated, multidisciplinary approach to ensure optimal outcomes. This case highlights the value of advanced anaesthetic and surgical techniques, real-time intraoperative monitoring, and personalized anesthetic strategies in achieving successful correction of complex spinal deformities while minimizing perioperative risks.

摘要

儿童严重脊柱侧凸的治疗,尤其是那些患有先天性椎体异常的儿童,是一项艰巨的挑战,需要高度协调的多学科方法。在本病例报告中,我们深入探讨了一名11岁女性的复杂治疗过程,该女性被诊断为极度脊柱侧凸(Cobb角90°),并伴有肋骨和椎体发育异常。这种独特的情况不仅需要手术技术的精准性,还需要先进的麻醉策略和实时术中监测,以确保取得成功的结果。在接受一次大型脊柱畸形矫正和稳定手术时,患者受益于前沿技术和量身定制的麻醉干预措施,这些措施旨在降低此类复杂手术的固有风险。值得注意的是,她的围手术期过程完全顺利,术后取得了出色的临床效果。本病例强调了整体协作护理模式的重要性——骨科医生、麻醉医生和专业支持团队协同工作,以应对先天性脊柱异常的复杂性。关键临床信息 对于患有先天性椎体异常的儿科患者,严重脊柱侧凸的治疗需要高度协调的多学科方法,以确保最佳结果。本病例突出了先进麻醉和手术技术、实时术中监测以及个性化麻醉策略在成功矫正复杂脊柱畸形同时最小化围手术期风险方面的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/3d50f1e76099/omaf081f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/ad710e3a1c2c/omaf081f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/65434e84b5c1/omaf081f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/3d50f1e76099/omaf081f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/ad710e3a1c2c/omaf081f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/65434e84b5c1/omaf081f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2334/12202294/3d50f1e76099/omaf081f3.jpg

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本文引用的文献

1
Anesthesia and Perioperative Management for Surgical Correction of Neuromuscular Scoliosis in Children: A Narrative Review.儿童神经肌肉型脊柱侧弯手术矫正的麻醉及围手术期管理:一项叙述性综述
J Clin Med. 2023 May 24;12(11):3651. doi: 10.3390/jcm12113651.
2
Spine deformity care: a team effort.脊柱畸形护理:团队合作。
Spine Deform. 2021 Mar;9(2):311-313. doi: 10.1007/s43390-021-00298-3.
3
Preoperative Maximization to Reduce Complications in Spinal Surgery.脊柱手术术前优化以减少并发症
Global Spine J. 2020 Jan;10(1 Suppl):45S-52S. doi: 10.1177/2192568219882349. Epub 2020 Jan 6.
4
Correction of kyphoscoliosis.脊柱后凸侧弯的矫正。
Eur Spine J. 2013 Dec;22(12):2918-20. doi: 10.1007/s00586-013-3101-1.
5
The prevention of neural complications in the surgical treatment of scoliosis: the role of the neurophysiological intraoperative monitoring.脊柱侧凸手术治疗中神经并发症的预防:神经生理术中监测的作用。
Eur Spine J. 2011 May;20 Suppl 1(Suppl 1):S105-14. doi: 10.1007/s00586-011-1756-z. Epub 2011 Mar 18.
6
Management of severe spinal deformity: scoliosis and kyphosis.严重脊柱畸形的治疗:脊柱侧凸和后凸。
Spine (Phila Pa 1976). 2010 Dec 1;35(25):2186-92. doi: 10.1097/BRS.0b013e3181feab19.
7
Postoperative pain management following scoliosis surgery.脊柱侧弯手术后的术后疼痛管理。
Curr Opin Anaesthesiol. 2008 Jun;21(3):313-6. doi: 10.1097/ACO.0b013e3282f82baa.