title: Correction of Spinal Deformity on a Lung Transplantation Recipient.
abstract: BACKGROUND
  The coexistence of lung disease and scoliosis entails a dramatic situation. There are no papers reporting scoliosis surgery in patients who suffered lung transplantation.
  
  
  OBJECTIVE
  To describe the case of a patient who underwent surgery to correct progressive spinal deformity after two consecutive lung transplants.
  
  
  METHODS
  Case report, including review of patient records, imaging and pulmonary function tests, and literature review.
  
  
  METHODS
  A 9-year-old woman diagnosed of idiopathic pulmonary fibrosis and progressive scoliosis underwent lung transplant. Retransplantation of right lung was performed at the age of 14 due to chronic rejection. When she was 16, respiratory function was stable and spinal deformity severely impaired her quality of life. Patient and family demanded a surgical correction. At that moment, she had severe osteoporosis and immunosuppression as a result of anti-rejection therapy. The pattern was a severe double thoracic curve T1-T6 89° and T7-L1 139°. To correct it, a posterior instrumented spine fusion from T2 to L4 using a hybrid configuration was performed.
  
  
  RESULTS
  No significant complications occurred in perioperative, postoperative, and midterm follow-up periods. Solid fusion was achieved and patient was satisfied with surgery. Unfortunately, chronic lung graft rejection worsened her long-term general status.
  
  
  CONCLUSIONS
  Scoliosis surgery on lung transplant recipients is feasible, regardless of potential complications related to immunosuppression and osteoporosis. The goal is to improve quality of life.
authors.affiliation: Department of Orthopedic Surgery, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain. Electronic address: jose.andres@vhebron.net.
authors.forename: José Vicente
authors.initials: JV
authors.lastname: Andrés Peiró
authors.affiliation: Department of Orthopedic Surgery, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
authors.forename: Joan Bagó
authors.initials: JB
authors.lastname: Granell
authors.affiliation: Department of Anesthesiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
authors.forename: Montserrat Feliu
authors.initials: MF
authors.lastname: Moret
authors.affiliation: Department of Pediatrics, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
authors.forename: Antonio Moreno
authors.initials: AM
authors.lastname: Galdó
keywords: Lung transplantation; Pediatric transplant; Scoliosis; Spine deformity; Spine surgery