Nicole J. Levin, Alex Ghorishi, Neil Charnowitz, Andrew Rosenthal and Jordan Ditchek
Background: The purpose of this paper is to review the occurrence and management of a tension pneumothorax which was exacerbated statuspost posterior spinal surgery.
Methods: Intraoperative reports, imaging, and pertinent medical records were retrospectively reviewed for a patient who underwent posterior spinal surgery with a tiny apical pneumothorax and subsequently developed into a major pneumothorax. The clinical signs imperative to recognition and prompt treatment were discussed.
Results: Unrecognized disruption of the pleural cavity during posterior spinal surgery caused the exacerbation of bilateral pneumothoraces. The patient was successfully treated with finger thoracostomy and chest tube insertion.
Conclusion: Posterior spinal surgery is an invasive procedure with the potential for serious complications such as the exacerbation of a previous non-surgical pneumothorax. A low index of suspicion is imperative due to the potentially lethal nature of pneumothoraces. Vital signs, pulmonary exam findings, portable radiography, and sonography equipment are all invaluable to the accurate diagnosis and early intervention for patients with pneumothoraces.
Level of Evidence: Case Report.
Study type: Diagnostic.
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