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Pneumomediastinum, subcutaneous emphysema, and tracheal tear in the early postoperative period of spinal surgery in a paraplegic achondroplastic dwarf.
[achondroplasia]
Achondroplasia
was
first
described
in
1878
and
is
the
most
common
form
of
human
skeletal
dysplasia
.
Spinal
manifestations
include
thoracolumbar
kyphosis
,
foramen
magnum
,
and
spinal
stenosis
.
Progressive
kyphosis
can
result
in
spinal
cord
compression
and
paraplegia
due
to
the
reduced
size
of
spinal
canal
.
The
deficits
are
typically
progressive
,
presenting
as
an
insidious
onset
of
paresthesia
,
followed
by
the
inability
to
walk
and
then
by
urinary
incontinence
.
Paraplegia
can
be
the
result
of
direct
pressure
on
the
cord
by
bone
or
the
injury
to
the
anterior
spinal
vessels
by
a
protruding
bone
.
Surgical
treatment
consists
of
posterior
instrumentation
,
fusion
with
total
wide
laminectomy
at
stenosis
levels
,
and
anterior
interbody
support
.
Pedicle
screws
are
preferred
for
spinal
instrumentation
because
wires
and
hooks
may
induce
spinal
cord
injury
due
to
the
narrow
spinal
canal
.
Pedicle
lengths
are
significantly
shorter
,
and
20
-
25
 
mm
long
screws
are
appropriate
for
lower
thoracic
and
lumbar
pedicles
in
adult
achondroplastic
There
is
no
information
about
the
appropriate
length
of
screws
for
the
upper
thoracic
pedicles
.
Tracheal
injury
due
to
inappropriate
pedicle
screw
length
is
a
rare
complication
.
We
report
an
extremely
rare
case
of
tracheal
tear
due
to
posterior
instrumentation
and
its
management
in
the
early
postoperative
period
.
Diseases
Validation
Diseases presenting
"kyphosis"
symptom
achondroplasia
child syndrome
cohen syndrome
focal myositis
thoracic outlet syndrome
This symptom has already been validated