Rib fixation for flail chest physiology and the facilitation of safe prone spinal surgery: illustrative case.
prone
rib fracture
rib plating
spine surgery
trauma
Journal
Journal of neurosurgery. Case lessons
ISSN: 2694-1902
Titre abrégé: J Neurosurg Case Lessons
Pays: United States
ID NLM: 9918227275606676
Informations de publication
Date de publication:
21 Nov 2022
21 Nov 2022
Historique:
received:
20
08
2022
accepted:
07
10
2022
entrez:
22
11
2022
pubmed:
23
11
2022
medline:
23
11
2022
Statut:
epublish
Résumé
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. 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. 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.
Sections du résumé
BACKGROUND
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
METHODS
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
CONCLUSIONS
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.
Identifiants
pubmed: 36411547
doi: 10.3171/CASE22337
pii: CASE22337
pmc: PMC9678797
doi:
pii:
Types de publication
Journal Article
Langues
eng
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