Correction of Spinal Deformity on a Lung Transplantation Recipient

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• 作者：José ; Vicente André ; s Peir&oacute ; MD^a ; ^{jose.andres@vhebron.net} ; Joan Bag&oacute ; Granell ; PhD^a ; Montserrat Feliu Moret ; MD^b ; Antonio Moreno Gald&oacute ; PhD^c
• 关键词：Scoliosis ; Spine deformity ; Spine surgery ; Lung transplantation ; Pediatric transplant
• 刊名：Spine Deformity
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：5
• 期：1
• 页码：72-76
• 全文大小：750 K
• 卷排序：5

文摘

The coexistence of lung disease and scoliosis entails a dramatic situation. There are no papers reporting scoliosis surgery in patients who suffered lung transplantation.PurposeTo describe the case of a patient who underwent surgery to correct progressive spinal deformity after two consecutive lung transplants.Study DesignCase report, including review of patient records, imaging and pulmonary function tests, and literature review.MethodsA 9-year-old woman diagnosed of idiopathic pulmonary fibrosis and progressive scoliosis underwent lung transplant. Retransplantation of right lung was performed at the age of 14 due to chronic rejection. When she was 16, respiratory function was stable and spinal deformity severely impaired her quality of life. Patient and family demanded a surgical correction. At that moment, she had severe osteoporosis and immunosuppression as a result of anti-rejection therapy. The pattern was a severe double thoracic curve T1–T6 89° and T7–L1 139°. To correct it, a posterior instrumented spine fusion from T2 to L4 using a hybrid configuration was performed.ResultsNo significant complications occurred in perioperative, postoperative, and midterm follow-up periods. Solid fusion was achieved and patient was satisfied with surgery. Unfortunately, chronic lung graft rejection worsened her long-term general status.ConclusionsScoliosis surgery on lung transplant recipients is feasible, regardless of potential complications related to immunosuppression and osteoporosis. The goal is to improve quality of life.