Multidisciplinary treatment of severe spinal deformity complicated with severe cardiopulmonary dysfunction: a case report.

IF 3.2 3区医学 Q1 PEDIATRICS

Italian Journal of Pediatrics Pub Date : 2025-03-24 DOI:10.1186/s13052-025-01925-9

Beiyu Xu, Chao Li, Longtao Qi, Yao Zhao, Wence Wu, Chengxian Yang, Ranlv Zhu, Zhengrong Yu, Chunde Li

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引用次数: 0

Abstract

Background: Severe spinal deformity (Cobb angle > 90°) often leads to cardiopulmonary dysfunction, posing significant surgical risks. We report a rare case of severe kyphoscoliosis with cardiopulmonary failure treated with non-invasive ventilation, anti-shock treatment, Halo-pelvic traction (HPT), and orthopedic surgery, emphasizing the importance of multidisciplinary cooperation.

Case presentation: A 13-year-old Boy with genetic suspicion of distal arthrogryposis (Type 5D) presented with Cobb angles of 94° (scoliosis) and 69° (kyphosis), respiratory failure (PO₂ 36.3 mmHg), and pre-shock status. A multidisciplinary team stabilized the patient using non-invasive ventilation, nutritional optimization and HPT. Post-traction correction rates reached 46.8% (coronal) and 53.6% (sagittal). Subsequent posterior spinal fusion (T1-L5) achieved 69% correction, resolving cardiopulmonary dysfunction and resulting in a highly satisfactory therapeutic outcome.

Conclusions: This case illustrates a case with severe spinal deformity combined with extremely severe cardiopulmonary dysfunction and highlights the importance of multidisciplinary cooperation in high-risk pediatric patients.

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严重脊柱畸形合并严重心肺功能障碍的多学科治疗1例。

背景：严重的脊柱畸形（Cobb角bbb90°）常导致心肺功能障碍，具有显著的手术风险。我们报告一例罕见的严重后凸脊柱侧凸合并心肺衰竭的病例，采用无创通气、抗休克治疗、halo -骨盆牵引（HPT）和骨科手术治疗，强调多学科合作的重要性。病例介绍：13岁男孩，遗传怀疑远端关节挛缩（5D型），表现为Cobb角94°（脊柱侧凸）和69°（后凸），呼吸衰竭（PO2 36.3 mmHg），休克前状态。一个多学科团队使用无创通气、营养优化和HPT稳定了患者。牵引后矫正率分别为冠状面46.8%和矢状面53.6%。随后的后路脊柱融合术（T1-L5）矫正率达到69%，解决了心肺功能障碍，获得了非常满意的治疗结果。结论：本病例是一例严重脊柱畸形合并极严重心肺功能障碍的病例，突出了儿科高危患者多学科合作的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Italian Journal of Pediatrics PEDIATRICS-

CiteScore

6.10

自引率

13.90%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Italian Journal of Pediatrics is an open access peer-reviewed journal that includes all aspects of pediatric medicine. The journal also covers health service and public health research that addresses primary care issues. The journal provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field. Italian Journal of Pediatrics, which commenced in 1975 as Rivista Italiana di Pediatria, provides a high-quality forum for pediatricians and other healthcare professionals to report and discuss up-to-the-minute research and expert reviews in the field of pediatric medicine. The journal will continue to develop the range of articles published to enable this invaluable resource to stay at the forefront of the field.