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Fulltext Scoliosis in a patient with lipodystrophy--treatment difficulties and literature review

Lim HH, Chong CS

Med J Malaysia, 1999 Sep;54(3):368-70.
PMID: 11045066

A 12 year-old Chinese schoolgirl presented with left-sided scoliosis at the age of 9 years. She has a rare defect in lipid metabolism, which is not known to be associated with spinal deformity. Her scoliotic curve deteriorated despite bracing. We report a rare occurrence of scoliosis in patient with lipodystrophy and the difficulty of using instrumented fusion in treating this condition.

Matched MeSH terms: Scoliosis/complications*
Percutaneous transvenous mitral commissurotomy in patients with severe kyphoscoliosis

Ramasamy D, Zambahari R, Fu M, Yeh KH, Hung JS

Cathet Cardiovasc Diagn, 1993 Sep;30(1):40-4.
PMID: 8402863

Because transseptal catheterization is felt to be contraindicated in patients with severe kyphoscoliosis, there have been no reports of percutaneous transvenous mitral commissurotomy performed in such patients. This report describes percutaneous transvenous mitral commissurotomy in three patients with severe thoracic kyphoscoliosis, with special emphasis on the transseptal puncture technique. Biplane right atrial angiography and the contrast septal flush method are very useful in landmark selection for a safe transseptal puncture.

Matched MeSH terms: Scoliosis/complications*
Posterior Spinal Fusion in a Scoliotic Patient With Congenital Heart Block Treated With Pacemaker: An Intraoperative Technical Difficulty

Wong TS, Abu Bakar J, Chee KH, Hasan MS, Chung WH, Chiu CK, et al.

Spine (Phila Pa 1976), 2019 02 15;44(4):E252-E257.
PMID: 30086081 DOI: 10.1097/BRS.0000000000002828

STUDY DESIGN: Case report.
OBJECTIVE: To describe the technical difficulties on performing posterior spinal fusion (PSF) on a pacemaker-dependent patient with complete congenital heart block and right thoracic scoliosis.
SUMMARY OF BACKGROUND DATA: Congenital complete heart block requires pacemaker implantation at birth through thoracotomy, which can result in scoliosis. Corrective surgery in this patient was challenging. Height gain after corrective surgery may potentially cause lead dislodgement. The usage of monopolar electrocautery may interfere with the function of the implanted cardiac device.
METHODS: A 17-year-old boy was referred to our institution for the treatment of right thoracic scoliosis of 70°. He had underlying complete congenital heart block secondary to maternal systemic lupus erythematosus. Pacemaker was implanted through thoracotomy since birth and later changed for four times. PSF was performed by two attending surgeons with a temporary pacing inserted before the surgery. The monopolar electrocautery device was used throughout the surgery.
RESULTS: The PSF was successfully performed without any technical issues and complications. Postoperatively, his permanent pacemaker was functioning normally. Three days later, he was recovering well and was discharged home from hospital.
CONCLUSION: This case indicates that PSF can be performed successfully with thoughtful anticipation of technical difficulties on a pacemaker-dependent patient with underlying congenital heart block.
LEVEL OF EVIDENCE: 5.

Matched MeSH terms: Scoliosis/complications*
A bizarre case of accessory larynx in an infant with OEIS syndrome

Wong TL, Baki MM, Ishak S, See GB

Int J Pediatr Otorhinolaryngol, 2018 Nov;114:134-137.
PMID: 30262351 DOI: 10.1016/j.ijporl.2018.08.037

We report a bizarre case of accessory larynx in an infant with OEIS syndrome (omphalocele, cloacal exstrophy, imperforated anus & spinal defects). This is the first reported case in literature of a duplicate accessory larynx which is a mirror image of the true larynx. A congenital duplication of the larynx is a rare anomaly and can present in various forms. In this case, the infant presented with recurrent lung infection and inability to wean off oxygen. Scope revealed severe laryngomalacia in addition to the accessory larynx. Hence, supraglottoplasty was done with aim to resolve the lung and airway problem.

Matched MeSH terms: Scoliosis/complications*
Fulltext Aberrant left brachiocephalic vein is a contraindication for anterior cervicothoracic approach

Ong EKS, Wong TS, Chung WH, Chiu CK, Saw A, Hasan MS, et al.

J Orthop Surg (Hong Kong), 2019 10 17;27(3):2309499019879213.
PMID: 31615339 DOI: 10.1177/2309499019879213

Aberrant left brachiocephalic vein is a rare condition. Its occurrence in patients requiring anterior cervicothoracic approach for severe kyphoscoliosis has not been described. A 16-year-old male with neurofibromatosis and severe upper thoracic kyphoscoliosis presented to us with curve progression. Halo gravity traction was attempted but failed to achieve significant correction. Subsequently, he underwent halo-pelvic traction and later Posterior Spinal Fusion (PSF) from C2 to T10. Second-stage anterior cervicothoracic approach with anterior fibula strut grafting was planned; however, preoperative computed tomography angiography revealed an aberrant left brachiocephalic vein with an anomalous retrotracheal and retroesophageal course, directly anterior to the T5/T6 vertebrae (planned anchor site for fibula strut graft) before draining into superior vena cava. Therefore, surgery was abandoned due to the risks associated with this anomaly. Aberrant left brachiocephalic vein is rare, the presence of which could be a contraindication for anterior cervicothoracic approach. Assessment of the anterior neurovascular structures is crucial in preoperative planning.

Matched MeSH terms: Scoliosis/complications