Congenital scoliosis with associated rib fusions: nursing care of patients following VEPTR insertion.
Congenital scoliosis with associated rib fusions, flail chest syndrome and hypoplastic thorax may create a progressive 3-dimensional deformity of the thorax, thereby inhibiting normal lung growth and respiratory function leading to respiratory insufficiency. The recently coined term for this condition is thoracic insufficiency syndrome (TIS). Traditional spine-based surgical procedures to correct congenital scoliosis with rib fusions inhibit the growth of the spine further, potentially worsening TIS and leading to respiratory problems during young adulthood. The dynamic interaction between the spine, ribs, and lungs was not addressed with these spine-focused procedures. This article explains TIS, discusses surgical treatment, and highlights unique aspects of postoperative nursing care. A case study is used for further explanation.
Department of Orthopaedics, Children's Hospital Boston, Boston, MA, USA.
Rachel
R
DiFazio
Diane
D
Tubman
D000015:Abnormalities, Multiple / Q000601:surgery*; D002675:Child, Preschool; D005409:Flail Chest / Q000209:etiology; D006801:Humans; D008297:Male; D009730:Nursing Assessment; D016530:Orthopedic Nursing / Q000379:methods; D019857:Osteogenesis, Distraction / Q000379:methods; D010371:Pediatric Nursing / Q000379:methods; D011182:Postoperative Care / Q000379:methods / Q000451:nursing; D019919:Prosthesis Implantation / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D012131:Respiratory Insufficiency / Q000209:etiology; D012272:Ribs / Q000002:abnormalities*; D012600:Scoliosis / Q000151:congenital / Q000601:surgery; D013577:Syndrome; D013905:Thoracoplasty / Q000295:instrumentation / Q000379:methods* / Q000451:nursing; D013907:Thoracostomy; D013909:Thorax / Q000002:abnormalities*