First Surgical Experience Treating Scoliosis Using HGT and ECMO: a Case Report

Overview

Journal Spine Deform

Publisher Springer Nature

Date 2022 Sep 19

PMID 36121561

Authors

Oriol Pujol

Felipe Moreira

Joan Balcells

Rosario Nuno

Antonio Moreno

Ferran Pellise

Affiliations

Soon will be listed here.

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.

References

Eby S, Hilaire T, Glotzbecker M, Smith J, White K, Larson A . Thoracogenic spinal deformity: a rare cause of early-onset scoliosis. J Neurosurg Spine. 2018; 29(6):674-679. PMC: 6431290. DOI: 10.3171/2018.4.SPINE171389. View

Kapoor M, Laham S, Sawyer J . Children at risk identified in an urban scoliosis school screening program: a new model. J Pediatr Orthop B. 2008; 17(6):281-7. DOI: 10.1097/BPB.0b013e328311d4d8. View

Wong H, Hui J, Rajan U, Chia H . Idiopathic scoliosis in Singapore schoolchildren: a prevalence study 15 years into the screening program. Spine (Phila Pa 1976). 2005; 30(10):1188-96. DOI: 10.1097/01.brs.0000162280.95076.bb. View

Russell K, Barnhart D, Rollins M, Hedlund G, Scaife E . Musculoskeletal deformities following repair of large congenital diaphragmatic hernias. J Pediatr Surg. 2014; 49(6):886-9. DOI: 10.1016/j.jpedsurg.2014.01.018. View

Harting M . Congenital diaphragmatic hernia-associated pulmonary hypertension. Semin Pediatr Surg. 2017; 26(3):147-153. DOI: 10.1053/j.sempedsurg.2017.04.008. View

Lin J . Extracorporeal Membrane Oxygenation for Severe Pediatric Respiratory Failure. Respir Care. 2017; 62(6):732-750. DOI: 10.4187/respcare.05338. View

Khan K, Khan F . Pulmonary hypertensive crisis and its efficient management. A Case report and literature review. J Pak Med Assoc. 2017; 67(6):936-938. View

Nemani V, Kim H, Bjerke-Kroll B, Yagi M, Sacramento-Dominguez C, Akoto H . Preoperative halo-gravity traction for severe spinal deformities at an SRS-GOP site in West Africa: protocols, complications, and results. Spine (Phila Pa 1976). 2015; 40(3):153-61. DOI: 10.1097/BRS.0000000000000675. View

Garabekyan T, Hosseinzadeh P, Iwinski H, Muchow R, Talwalkar V, Walker J . The results of preoperative halo-gravity traction in children with severe spinal deformity. J Pediatr Orthop B. 2013; 23(1):1-5. DOI: 10.1097/BPB.0b013e32836486b6. View

10.

McIntosh A, Ramo B, Johnston C . Halo Gravity Traction for Severe Pediatric Spinal Deformity: A Clinical Concepts Review. Spine Deform. 2019; 7(3):395-403. DOI: 10.1016/j.jspd.2018.09.068. View

11.

Bogunovic L, Lenke L, Bridwell K, Luhmann S . Preoperative Halo-Gravity Traction for Severe Pediatric Spinal Deformity: Complications, Radiographic Correction and Changes in Pulmonary Function. Spine Deform. 2016; 1(1):33-39. DOI: 10.1016/j.jspd.2012.09.003. View

12.

Rinella A, Lenke L, Whitaker C, Kim Y, Park S, Peelle M . Perioperative halo-gravity traction in the treatment of severe scoliosis and kyphosis. Spine (Phila Pa 1976). 2005; 30(4):475-82. DOI: 10.1097/01.brs.0000153707.80497.a2. View

13.

Park D, Braaksma B, Hammerberg K, Sturm P . The efficacy of preoperative halo-gravity traction in pediatric spinal deformity the effect of traction duration. J Spinal Disord Tech. 2013; 26(3):146-54. DOI: 10.1097/bsd.0b013e318237828c. View

14.

Carmichael T, Walsh E, Roth S . Anticipatory use of venoarterial extracorporeal membrane oxygenation for a high-risk interventional cardiac procedure. Respir Care. 2002; 47(9):1002-6. View

15.

Zuin M, Rigatelli G, Daggubati R . Cardiac intensive care management of high-risk percutaneous coronary intervention using the venoarterial ECMO support. Heart Fail Rev. 2019; 25(5):833-846. DOI: 10.1007/s10741-019-09862-6. View

16.

Koraki E, Stachtari C, Stergiouda Z, Stamatopoulou M, Gkiouliava A, Sifaki F . Blood and fluid management during scoliosis surgery: a single-center retrospective analysis. Eur J Orthop Surg Traumatol. 2020; 30(5):809-814. DOI: 10.1007/s00590-020-02637-y. View