• World Neurosurg · Apr 2020

    Case Reports

    Stepwise Management of a Severe Thoracogenic Scoliosis in a Burned Child.

    • Tristan Langlais, Raphaël Pietton, Romain Laurent, Sophie Cassier, Isabelle Constant, Maurice Mimoun, and Raphaël Vialle.
    • The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases-Sorbonne University, Armand Trousseau Hospital, Paris, France; Department of Orthopedics, Children's Hospital, Toulouse, France. Electronic address: tristanlanglais@yahoo.fr.
    • World Neurosurg. 2020 Apr 1; 136: 399-402.e2.

    BackgroundSkin and soft tissue retraction secondary to burns of the trunk may induce severe and progressive thoracogenic spinal deformities in children. Its management is rarely described.Case DescriptionOur study reports a case of severe thoracic scoliosis in a 13-year-old adolescent, secondary to soft tissue retraction due to trunk burn in early childhood. The Cobb angle of the scoliosis was 100 degrees. The 3-stage surgical strategy consisted of scar excision and skin graft in the first stage, halo gravity traction in the second stage, and posterior correction and fusion of the spine in the third and final stage. The postoperative course was satisfactory, and late follow-up at 1 year showed stable correction of the spine, with satisfactory coronal and sagittal balance and good healing of skin and soft tissues.DiscussionWhile spinal deformities secondary to burns are rare, they require specific, sequential, and multidisciplinary medical and surgical management. Our surgical strategy was to treat skin and soft tissues retractions first and then address spinal deformity. We used halo-gravity traction between the 2 surgical stages to help improve the spine deformity correction while reducing the risk of neurologic complications.Copyright © 2019 Elsevier Inc. All rights reserved.

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