Rare case of Pectus excavatum, kyphoscoliosis associated with thoracolumbar spinal stenosis reported

Pectus excavatum is a condition in which a person's breastbone is sunken into his or her chest. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. Pectus excavatum is a condition in which the person's breastbone is sunken into the chest. Thoracolumbar spinal stenosis and kyphoscoliosis was seen in patients with pectus excavatum. It can be caused by ossification of the ligamentum flavum, which is rare in patients with pectus excavatum.

Pectus excavatum can range from mild to severe. Those with a mild condition often do not have symptoms. Those with moderate-to-severe conditions may have symptoms such as shortness of breath, fatigue, exercise intolerance/limitations and chest pain. With a severe case of pectus excavatum, there can be compression of the heart. Pectus excavatum may also be associated with scoliosis in some children. Children with pectus excavatum may experience some negative effects on their self-esteem due to the appearance of the chest.

The researchers reported a 26-year-old woman presented bilateral lower extremities weakness and numbness for two months, progressive worsening. She has been diagnosed as thoracolumbar spinal stenosis with ossification of the ligamentum flavum, and thoracolumbar kyphoscoliosis associated with pectus excavatum. The posterior instrumentation, decompression with laminectomy, and de-kyposis procedure with multilevel ponte osteotomy were performed. Her postoperative course was uneventful and followed up regularly. Good neurologic symptoms improvement and spinal alignment were achieved.

Thus, the researchers concluded that pectus excavatum, kyphoscoliosis associated with thoracolumbar spinal stenosis is rare, and thus her treatment options are very challenging. Extensive laminectomy decompression and de-kyphosis procedures can achieve good improvement of neurologic impingement and spinal alignment.

Reference:

Zhao, S., Xue, X., Li, K. et al. Pectus excavatum, kyphoscoliosis associated with thoracolumbar spinal stenosis: a rare case report and literature review. BMC Surg 22, 266 (2022). https://doi.org/10.1186/s12893-022-01716-7