Late bronchus perforation due to spinal implant compression
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We report a rare case of perforation of the intermediate bronchus by a loosened osteosynthetic implant, 8 years after the patient had undergone surgery for right thoracic scoliosis with the VDS instrumentation. Due to chronic lung inflammatory alteration caused by bronchial obstruction, lower bi-lobectomy was performed. We believe that spinal growth and progression of idiopathic scoliosis can lead to implant failure, while the variance in intrathoracic topographic relations and respiratory excursion facilitate it's penetration into the bronchus. In order to impede foreign body perforation of mediastinal structures and to reduce its complications, preventive methods, along with timely diagnostics, are required. Atelectatic and chronic inflammatory alterations that compromise adequate lung ventilation could require a resection procedure...

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