Rib fixation for flail chest physiology and the facilitation of safe prone spinal surgery: illustrative case.

Autor: Wessell JE; Departments of1Neurosurgery and., Pereira MP; Departments of1Neurosurgery and., Eriksson EA; 2Surgery, Medical University of South Carolina, Charleston, South Carolina., Kalhorn SP; Departments of1Neurosurgery and.
Jazyk: angličtina
Zdroj: Journal of neurosurgery. Case lessons [J Neurosurg Case Lessons] 2022 Nov 21; Vol. 4 (21). Date of Electronic Publication: 2022 Nov 21 (Print Publication: 2022).
DOI: 10.3171/CASE22337
Abstrakt: Background: Spine fractures are frequently associated with additional injuries in the trauma setting, with chest wall trauma being particularly common. Limited literature exists on the management of flail chest physiology with concurrent unstable spinal injury. The authors present a case in which flail chest physiology precluded safe prone surgery and after rib fixation the patient tolerated spinal fixation without further issue.
Observations: Flail chest physiology can cause cardiovascular decompensation in the prone position. Stabilization of the chest wall addresses this instability allowing for safe prone spinal surgery.
Lessons: Chest wall fixation should be considered in select cases of flail chest physiology prior to stabilization of the spinal column in the prone position. Further research is necessary to identify patients that are at highest risk to not tolerate prone surgery.
Databáze: MEDLINE