[Cephalad movement of the carina due to CD (Cotrel-Dubousset) instrumentation for idiopathic scoliosis].
Recently we experienced a case of tracheal tube obstruction due to the upward displacement of carina during CD (Cotrel-Dubousset) instrumentation for idiopathic scoliosis. Therefore, we hypothesized that CD instrumentation may affect the position of the carina as a result of correction of chest deformity, and studied the displacement of carina before and after CD instrumentation on chest X-ray in 12 patients with scoliosis. The length between the bottom of the 6th cervical vertebral body and the carina was measured by using chest X-ray before and after the correction. In all patients studied, cephalad movement of the carina was observed, and it was more than 1.00 cm in 5 patients. The maximal movement of the carina was 1.59 cm. The tracheal length after the correction was significantly shorter than before (P < 0.01). These results suggest that the carina may be displaced upwards due to the correction by the CD instrumentation, and that such induced displacement may affect the tracheal tube position and obstruct the tube during the operation.
Furuno
K
K
Department of Anesthesiology and Resuscitology, Kochi Medical School, Nankoku.
Tsuchiya
M
M
Ushida
T
T
Kang
M Y
MY
Kanbara
T
T
Yamamoto
H
H
Manabe
M
M
D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007431:Intraoperative Complications; D007442:Intubation, Intratracheal; D008297:Male; D012600:Scoliosis / Q000601:surgery*