Preoperative halo-pelvic traction leading to near-complete airway obstruction in a child with severe thoracic lordosis and scoliosis: a case report.

Abstract

Background: Halo-pelvic traction is a relatively safe treatment for preoperative spinal deformity correction in patients with severe scoliosis. Common device-related complications include local infection, back discomfort, and nerve compression symptoms. However, there are potential risks of mechanical compression of bronchial structures, especially in patients with severe thoracic lordosis and scoliosis, which can lead to life-threatening airway obstruction.

Case presentation: A 11-year-old boy diagnosed with neurofibromatosis received preoperative halo-pelvic traction for forty days with a Cobb angle reduced from 99° to 51°. On operation day, he experienced near-complete airway obstruction and hypoxemia post-anesthesia induction, which was successfully resolved by releasing the traction. The posterior correction surgery was performed as scheduled and the child was extubated uneventfully.

Conclusions: Airway obstruction is a rare but severe complication of halo-pelvic traction, emphasizing the importance of careful airway management and continuous monitoring in pediatric patients with spinal deformities. Ensuring thorough preoperative evaluations and being prepared for potential airway emergencies are crucial steps in optimizing patient outcomes during such complex orthopedic interventions.