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Updated: Jun 16, 2026

Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
Vascular access challenge on a patient with cerebral palsy and severe kyphoscoliosis
Sharon Leung1, Amit D Malhotra, Lewis A Eisen
1Division of Critical Care Medicine, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
Abstract:
We report a case of vascular assess challenge on a patient with severe kyphoscoliosis and joint contractures. Multiple internal jugular (IJ) central venous catheters (CVC) and a peripherally inserted central catheter (PICC) catheterization were attempted via ultrasound guidance and all resulted in malposition. The PICC attempt fortuitously pushed a malpositioned IJ into the correct position. Computed tomography (CT) demonstrated a narrow thoracic inlet with no definite venous stenoses. Therefore, severe chest wall deformity, a narrow thoracic inlet and inadequate positioning of the patient secondary to his contractures all contributed to the malposition of the PICC and CVCs.
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