Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report

G. Scuderi, D. P. Sanders, R. M. Brustowicz, C. B. Berde, Andrew Colin, J. Allen, G. B. Healy, J. E. Hall

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

The association between spinal curvature and respiratory function has long been established. Accordingly, the goals of spinal fusion have been to prevent the long-term compromise in respiratory function associated with progressive curvature. The introduction of the Harrington instrumentation system, while providing increased stabilization for spinal fusion, has been associated with many complications. The compression apparatus has been used effectively in the treatment of kyphotic deformities of the thoracic spine, and has been used in conjunction with distraction successfully in the treatment of idiopathic scoliosis. With the passage of time, in spite of Harrington's recommendation to use both the distraction and compression, it has been apparent that problems can arise from the routine use of compression. Winter et al have warned of the use of the compression apparatus in the hypokyphotic thoracic spine, as increased thoracic lordosis has clearly been associated with marked effect in decreased pulmonary function. While this effect has been considered a result of decreased anteroposterior diameter of the thoracic cavity and attendant decreased total lung volume, the direct effect on the bronchi of thoracic vertebral body rotation in progressive lordoscoliosis has been largely unrecognized. This case represents an extreme example of the effect of the use of a compression device in a hypokyphotic idiopathic curve. In this patient, pulmonary compromise developed secondary to diminished lung volumes, extrinsic compression of the right mainstem bronchus by the lordotic thoracic spine, and incidental weakness of the left hemidiaphragm.

Original languageEnglish
Pages (from-to)110-114
Number of pages5
JournalSpine
Volume14
Issue number1
StatePublished - Jan 1 1989
Externally publishedYes

Fingerprint

Bronchi
Respiratory Insufficiency
Thorax
Lung
Spinal Fusion
Spine
Spinal Curvatures
Thoracic Cavity
Lordosis
Scoliosis
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Scuderi, G., Sanders, D. P., Brustowicz, R. M., Berde, C. B., Colin, A., Allen, J., ... Hall, J. E. (1989). Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report. Spine, 14(1), 110-114.

Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report. / Scuderi, G.; Sanders, D. P.; Brustowicz, R. M.; Berde, C. B.; Colin, Andrew; Allen, J.; Healy, G. B.; Hall, J. E.

In: Spine, Vol. 14, No. 1, 01.01.1989, p. 110-114.

Research output: Contribution to journalArticle

Scuderi, G, Sanders, DP, Brustowicz, RM, Berde, CB, Colin, A, Allen, J, Healy, GB & Hall, JE 1989, 'Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report', Spine, vol. 14, no. 1, pp. 110-114.
Scuderi G, Sanders DP, Brustowicz RM, Berde CB, Colin A, Allen J et al. Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report. Spine. 1989 Jan 1;14(1):110-114.
Scuderi, G. ; Sanders, D. P. ; Brustowicz, R. M. ; Berde, C. B. ; Colin, Andrew ; Allen, J. ; Healy, G. B. ; Hall, J. E. / Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report. In: Spine. 1989 ; Vol. 14, No. 1. pp. 110-114.
@article{91a289f28d024b7cadbc7a4a450da8e2,
title = "Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report",
abstract = "The association between spinal curvature and respiratory function has long been established. Accordingly, the goals of spinal fusion have been to prevent the long-term compromise in respiratory function associated with progressive curvature. The introduction of the Harrington instrumentation system, while providing increased stabilization for spinal fusion, has been associated with many complications. The compression apparatus has been used effectively in the treatment of kyphotic deformities of the thoracic spine, and has been used in conjunction with distraction successfully in the treatment of idiopathic scoliosis. With the passage of time, in spite of Harrington's recommendation to use both the distraction and compression, it has been apparent that problems can arise from the routine use of compression. Winter et al have warned of the use of the compression apparatus in the hypokyphotic thoracic spine, as increased thoracic lordosis has clearly been associated with marked effect in decreased pulmonary function. While this effect has been considered a result of decreased anteroposterior diameter of the thoracic cavity and attendant decreased total lung volume, the direct effect on the bronchi of thoracic vertebral body rotation in progressive lordoscoliosis has been largely unrecognized. This case represents an extreme example of the effect of the use of a compression device in a hypokyphotic idiopathic curve. In this patient, pulmonary compromise developed secondary to diminished lung volumes, extrinsic compression of the right mainstem bronchus by the lordotic thoracic spine, and incidental weakness of the left hemidiaphragm.",
author = "G. Scuderi and Sanders, {D. P.} and Brustowicz, {R. M.} and Berde, {C. B.} and Andrew Colin and J. Allen and Healy, {G. B.} and Hall, {J. E.}",
year = "1989",
month = "1",
day = "1",
language = "English",
volume = "14",
pages = "110--114",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Postoperative lordoscoliosis causing extrinsic compression of the right main stem bronchus and respiratory insufficiency. A case report

AU - Scuderi, G.

AU - Sanders, D. P.

AU - Brustowicz, R. M.

AU - Berde, C. B.

AU - Colin, Andrew

AU - Allen, J.

AU - Healy, G. B.

AU - Hall, J. E.

PY - 1989/1/1

Y1 - 1989/1/1

N2 - The association between spinal curvature and respiratory function has long been established. Accordingly, the goals of spinal fusion have been to prevent the long-term compromise in respiratory function associated with progressive curvature. The introduction of the Harrington instrumentation system, while providing increased stabilization for spinal fusion, has been associated with many complications. The compression apparatus has been used effectively in the treatment of kyphotic deformities of the thoracic spine, and has been used in conjunction with distraction successfully in the treatment of idiopathic scoliosis. With the passage of time, in spite of Harrington's recommendation to use both the distraction and compression, it has been apparent that problems can arise from the routine use of compression. Winter et al have warned of the use of the compression apparatus in the hypokyphotic thoracic spine, as increased thoracic lordosis has clearly been associated with marked effect in decreased pulmonary function. While this effect has been considered a result of decreased anteroposterior diameter of the thoracic cavity and attendant decreased total lung volume, the direct effect on the bronchi of thoracic vertebral body rotation in progressive lordoscoliosis has been largely unrecognized. This case represents an extreme example of the effect of the use of a compression device in a hypokyphotic idiopathic curve. In this patient, pulmonary compromise developed secondary to diminished lung volumes, extrinsic compression of the right mainstem bronchus by the lordotic thoracic spine, and incidental weakness of the left hemidiaphragm.

AB - The association between spinal curvature and respiratory function has long been established. Accordingly, the goals of spinal fusion have been to prevent the long-term compromise in respiratory function associated with progressive curvature. The introduction of the Harrington instrumentation system, while providing increased stabilization for spinal fusion, has been associated with many complications. The compression apparatus has been used effectively in the treatment of kyphotic deformities of the thoracic spine, and has been used in conjunction with distraction successfully in the treatment of idiopathic scoliosis. With the passage of time, in spite of Harrington's recommendation to use both the distraction and compression, it has been apparent that problems can arise from the routine use of compression. Winter et al have warned of the use of the compression apparatus in the hypokyphotic thoracic spine, as increased thoracic lordosis has clearly been associated with marked effect in decreased pulmonary function. While this effect has been considered a result of decreased anteroposterior diameter of the thoracic cavity and attendant decreased total lung volume, the direct effect on the bronchi of thoracic vertebral body rotation in progressive lordoscoliosis has been largely unrecognized. This case represents an extreme example of the effect of the use of a compression device in a hypokyphotic idiopathic curve. In this patient, pulmonary compromise developed secondary to diminished lung volumes, extrinsic compression of the right mainstem bronchus by the lordotic thoracic spine, and incidental weakness of the left hemidiaphragm.

UR - http://www.scopus.com/inward/record.url?scp=0024583392&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024583392&partnerID=8YFLogxK

M3 - Article

VL - 14

SP - 110

EP - 114

JO - Spine

JF - Spine

SN - 0362-2436

IS - 1

ER -