Severe thoracic lordoscoliosis can lead to life-threatening cardiopulmonary complications during surgery, highlighting the need for careful pre-operative clinical, spirometric, and radiographic assessment.
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May precipitate intraoperative cardiopulmonary collapse in severe lordoscoliosis; leaves open optimal preoperative assessment protocols.
A 15-year old girl underwent a posterior spinal fusion procedure for severe lordoscoliosis. On turning to the prone position acute posture-related upper airway obstruction occurred. During surgery, manipulation of the spine caused several episodes of loss of cardiac output. Retrospective assessment of the pre-operative chest X rays demonstrated approximation of the sternum and thoracic vertebrae, with evidence of tracheal narrowing at the level of the thoracic inlet. We feel that both complications were directly related to the severity of the lordoscoliosis and that careful pre-operative clinical, spirometric and X ray assessment should be undertaken in such patients.
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Bagshaw et al. (1995) studied this question.
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