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

TL;DR

This case report describes the successful treatment of a 13-year-old boy with severe spinal deformity and life-threatening heart and lung issues using a team-based approach.

Contribution

The paper presents a novel multidisciplinary treatment strategy for severe spinal deformity with cardiopulmonary failure in a high-risk pediatric patient.

Findings

Non-invasive ventilation and Halo-pelvic traction significantly improved the patient's spinal deformity and respiratory function.

Posterior spinal fusion achieved a 69% correction of deformity and resolved cardiopulmonary dysfunction.

Multidisciplinary cooperation was critical for managing a high-risk pediatric patient with severe spinal and cardiopulmonary issues.

Abstract

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.

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.

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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