Iatrogenic injury to long thoracic nerve following thoracotomy for right thoracic scoliosis in Marfan syndrome: a case report

Journal of Medical Case Reports

Farhad Hamzehzadeh¹  Ahmadreza Mirbolook²  Mirbahador Athari²  Saeid Safaei³  Parisa Azimi⁴  Taravat Yazdanian⁵ 

[1] Department of Orthopedic Surgery, Milad General Hospital, Tehran, Iran;Department of Orthopedic, Imam Hossain Medical Center, University of Shahid Beheshti Medical Sciences, Shahid Madani Street, Tehran, Iran;Department of Spine Surgery, Milad General Hospital, Tehran, Iran;Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, 19839-63113, Velenjak, Tehran, Iran;Parisa Azimi Neuroscience Research Center, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, 19839-63113, Velenjak, Tehran, Iran;School of Medicine, Capital Medical University, Beijing, China;

关键词: Marfan syndrome;    Thoracic scoliosis;    Long thoracic nerve;    Winged scapula;    Long thoracic nerve injury;   

DOI  :  10.1186/s13256-021-02755-z

来源: Springer

【 摘 要 】

BackgroundPatients with Marfan syndrome commonly require spinal deformity surgery. The purpose of this case report is to present a rare thoracotomy complication. We present the management of such a patient.Case summaryIn a known case of Marfan syndrome, an 18-year-old Persian man was admitted to our hospital with scoliosis. The patient underwent radiological examinations, and thoracic scoliosis of 70° was diagnosed. A right thoracotomy for anterior spinal fusion from the sixth rib and posterior spinal fusion were performed successfully. Two months later, he was readmitted because of winging of the right scapula due to serratus anterior palsy. Electromyography and nerve conduction velocity confirmed long thoracic nerve injury. Conservative treatment was provided. Ultimately, the patient recovered completely in the last follow-up visit 6 months after the surgery.DiscussionThis is the first report of ipsilateral winged scapula after thoracotomy. Attention needs to be paid to surgical techniques in patients with Marfan syndrome.

【 授权许可】

CC BY