Oriol Pujol1, Felipe Moreira2, Joan Balcells3, Rosario Nuño4, Antonio Moreno5, Ferran Pellise2. 1. Spinal Surgery Unit, Orthopedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. opujol@vhebron.net. 2. Spinal Surgery Unit, Orthopedic Surgery Department, Vall d'Hebron University Hospital, Universitat Autónoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. 3. Pediatric Critical Care Department, Vall d'Hebron University Hospital, Barcelona, Spain. 4. Pediatric Anesthesiology Department, Vall d'Hebron University Hospital, Barcelona, Spain. 5. Pediatric Pneumology Department, Vall d'Hebron University Hospital, Barcelona, Spain.
Abstract
CASE PRESENTATION: 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. CONCLUSIONS: 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.
CASE PRESENTATION: 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. CONCLUSIONS: 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.
Authors: Venu M Nemani; Han Jo Kim; Benjamin T Bjerke-Kroll; Mitsuru Yagi; Cristina Sacramento-Dominguez; Harry Akoto; Elias C Papadopoulos; Francisco Sanchez-Perez-Grueso; Ferran Pellise; Joseph T Nguyen; Irene Wulff; Jennifer Ayamga; Rufai Mahmud; Richard M Hodes; Oheneba Boachie-Adjei Journal: Spine (Phila Pa 1976) Date: 2015-02-01 Impact factor: 3.468
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