Lordoscoliosis and large intrathoracic airway obstruction.

Abstract

Case series. We report the treatment of 2 children with right main bronchus obstruction complicating thoracic lordoscoliosis. The preoperative investigation and treatment of large airway obstruction caused by lordoscoliosis has not been reported in the literature. Obstruction of the right main bronchus was confirmed before surgery by ventilation-perfusion scans, bronchogram, and computed tomography scan. Deformity correction was achieved using a submuscular growth rod construct in one child, and posterior spinal fusion in the other. Clinical examination and repeat ventilation-perfusion scans were performed 8 weeks after surgery. In both children, ventilation to the right "convex" lung was reestablished after surgery. Lung function improved in both patients after surgery. This is the first report of large airway obstruction associated with thoracic lordoscoliosis in which ventilation was reestablished after spinal deformity correction. Early deformity correction is indicated in such cases because of the risk of irreversible compromise to lung ventilation and perfusion.