Successful surgery for a neuromuscular scoliosis patient by pulmonary rehabilitation with forced vital capacity below 30%

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Abstract

A rare case of a 15-year-old male patient with neuromuscular scoliosis with forced vital capacity (FVC) below 30%, who went through a successful surgery without any pulmonary complications, is reported herein. The patient had obvious asymmetric shoulders and poor exercise tolerance. The Cobb’s angle of the main thoracic curve was 62.8°, and FVC in sitting position was 18% of predictive value. After skull traction and pulmonary rehabilitation, the FVC was still below 30%, and he finally went through surgery under this serious condition. By early pulmonary rehabilitation using home ventilator, he successfully recovered without any pulmonary complications. The patient had complete symptom remission and no deterioration of Cobb’s angle was found during follow-up.

Keywords

Neuromuscular scoliosis Pulmonary rehabilitation Forced vital capacity Home ventilator 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Informed consent

Informed consent was obtained from the patient mentioned in this article.

References

  1. 1.
    Rawlins BA, Winter RB, Lonstein JE et al (1996) Reconstructive spine surgery in pediatric patients with major loss in vital capacity. J Pediatr Orthop 16:284–292CrossRefPubMedGoogle Scholar
  2. 2.
    Kang SW (2006) Pulmonary rehabilitation in patients with neuromuscular disease. Yonsei Med J 47:307–314CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Takaso M, Nakazawa T, Imura T et al (2010) Surgical management of severe scoliosis with high risk pulmonary dysfunction in Duchenne muscular dystrophy: patient function, quality of life and satisfaction. Int Orthop 34:695–702CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Gill I, Eagle M, Mehta JS et al (2006) Correction of neuromuscular scoliosis in patients with preexisting respiratory failure. Spine (Phila Pa 1976) 31:2478–2483CrossRefGoogle Scholar
  5. 5.
    Modi HN, Suh SW, Hong JY et al (2011) Surgical correction of paralytic neuromuscular scoliosis with poor pulmonary functions. J Spinal Disord Tech 24:325–333CrossRefPubMedGoogle Scholar
  6. 6.
    Chong HS, Moon ES, Park JO et al (2011) Value of preoperative pulmonary function test in flaccid neuromuscular scoliosis surgery. Spine (Phila Pa 1976) 36:1391–1394CrossRefGoogle Scholar
  7. 7.
    Lee JW, Won YH, Choi WA et al (2013) Successful surgery for scoliosis supported by pulmonary rehabilitation in a Duchenne muscular dystrophy patient with forced vital capacity below 10%. Ann Rebabil Med 37(6):875–878CrossRefGoogle Scholar
  8. 8.
    Padman R, McNamara R (1990) Postoperative pulmonary complications in children with neuromuscular scoliosis who underwent posterior spinal fusion. Del Med J 62:999–1003PubMedGoogle Scholar
  9. 9.
    Mohamad F, Parent S, Pawelek J et al (2007) Perioperative complications after surgical correction in neuromuscular scoliosis. J Pediatr Orthop 27:392–397CrossRefPubMedGoogle Scholar
  10. 10.
    Master DL, Son-Hing JP, Poe-Kochert C et al (2011) Risk factors for major complications after surgery for neuromuscular scoliosis. Spine (Phila Pa 1976) 36:564–571CrossRefGoogle Scholar
  11. 11.
    Sussman MD (1984) Advantage of early spinal stabilization and fusion in patients with Duchenne muscular dystrophy. J Pediatr Orthop 4:532–537PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Spine Surgery; Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Orthopaedic Research InstituteFirst Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  2. 2.Department of Musculoskeletal OncologyFirst Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina
  3. 3.Research Center of Translational Medicine, First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina

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