Posterior spinal fusion for scoliosis after Fontan procedure: A case series

J Orthop Sci. 2018 Mar;23(2):294-298. doi: 10.1016/j.jos.2017.11.004. Epub 2017 Nov 23.

Abstract

Background: As the surgical treatment of scoliosis after a Fontan procedure is very challenging due to the risk of various perioperative complications, case reports are scarce. We herein describe three patients who were successfully treated for scoliosis following a Fontan procedure and discuss their clinical and radiological outcomes.

Methods: We retrospectively reviewed three cases of scoliosis treated by posterior spinal fusion after a Fontan procedure.

Results: Mean preoperative major curve Cobb angle was 83.7°, mean surgical time was 233.0 min, and mean blood loss was 1167 g. The mean correction rate of the major curve was 48.0%. Surgical outcome as evaluated by Scoliosis Research Society-22 patient questionnaires revealed acceptable results without any severe complications.

Conclusions: Corrective surgery for scoliosis after a Fontan procedure becomes a stronger option if cardiac insufficiency is prevented during the perioperative period and a conservative plan is carried out with minimal invasiveness and operation time.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Follow-Up Studies
  • Fontan Procedure / methods*
  • Humans
  • Intraoperative Complications / prevention & control*
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / surgery
  • Male
  • Radiography, Thoracic / methods
  • Retrospective Studies
  • Risk Assessment
  • Sampling Studies
  • Scoliosis / diagnostic imaging
  • Scoliosis / surgery*
  • Severity of Illness Index
  • Spinal Fusion / adverse effects
  • Spinal Fusion / methods*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / surgery
  • Treatment Outcome