Scoliosis Caused by Rib Fusion after Thoracotomy for Esophageal Atresia: A Case Report and Surgical Approach

J Orthop Case Rep. 2024 Jan;14(1):125-130. doi: 10.13107/jocr.2024.v14.i01.4172.

Abstract

Introduction: This case report abstract discusses scoliosis, a multifactorial three-dimensional spinal deformity, including lateral curvatures on the frontal plane characterized by Cobb angle measurement, vertebral rotation on the axial plane and sagittal deformity. Scoliosis can be mild, moderate, or severe, and if left untreated, it can lead to further deformity and compromise cardiopulmonary function. Scoliosis is classified into early onset and late onset, with idiopathic scoliosis being the most common form. Early-onset scoliosis has various etiologies, including idiopathic, congenital, neuromuscular, and syndromic. Early management is crucial to minimize complications, such as restrictive ventilatory disorder and pulmonary dysplasia. This case report focuses on an iatrogenic cause of scoliosis due to rib synostosis, which is not included in the classification. Treatment options include non-operative management and surgical interventions, with the use of vertical expandable prosthetic titanium rib (VEPTR) thoracoplasty to correct the spinal deformity.

Case report: This article illustrates the case of a 13-year-old girl who developed a left thoracic scoliosis caused by ribs fusion, following multiple right thoracotomies during childhood for esophageal atresia with tracheoesophageal fistula. No vertebral abnormalities were reported. Considering the young age of the girl, spinal fusion was not considered. A VEPTR associated with an excision of the fused ribs was used to treat this patient.

Conclusion: The aim of this article was to illustrate the importance of a regular follow-up for the patients who have undergone multiples thoracotomies during their childhood even without vertebral abnormalities and propose an early approach to avoid spinal fusion in early adulthood.

Keywords: Scoliosis; esophageal atresia; growing rods; musculoskeletal deformity; rib fusions; thoracotomy.

Publication types

  • Case Reports