Positional complications in spine surgery are not uncommon. Commonly encountered complications include ocular and aural, other than musculoskeletal injuries. However, development of Tietze’s syndrome due to malpositioning has not been reported till date. A 40-year-old male patient presented with postlaminectomy syndrome, for which posterior pedicle screw fixation and fusion was performed. Postoperatively, patient complained of new-onset pain associated with redness and swelling at parasternal region. After thorough radiological investigations, he was diagnosed with Tietze’s syndrome at 6th and 7th costo-cartilaginous junction. Tietze’s syndrome is itself a rare entity, and its association with malpositioning during prone positioning is uncommon. It is important for the surgeons to be aware of the condition as Tietze’s syndrome may be encountered as an off-centered complication due to malpositioning.
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Hiramuro-Shoji F, Wirth MA, Rockwood CA Jr. Atraumatic conditions of the sternoclavicular joint. J Shoulder Elbow Surg 2003;12:79–88.
Wolf E, Stern S. Costosternal syndrome: Its frequency and importance in differential diagnosis of coronary heart disease. Arch Intern Med 1976;136:189–91.
Tietze A. Tiber eine eigenartige Haufung von Fallen mit Dystrophic der Rippenknorpel. [About a peculiar accumulation of cases with dystrophy of costal cartilage] Berliner klinische Wochenschrift. Volume v. 58:2 1921. pp 829–31.
Store SD. Tietze’s syndrome. J Postgrad Med 1964;10:28–30.
Jelenko C 3rd. Tietze’s syndrome at the xiphisternal joint. South Med J 1974;67:818–20.
National Institutes of Health. Rare Diseases and Related Terms. National Institutes of Health; 2013. Available from: https://rarediseases.info.nih.gov/diseases/10100/tietze-syndrome. [Last accessed on 2018 Nov 04].
Jelenko C 3rd, Cowan GS Jr. Perichondritis (Tietze’s syndrome) at the xiphisternal joint: A mimic of severe disease. JACEP 1977;6:536–42.
Epstein SE, Gerber LH, Borer JS. Chest wall syndrome. A common cause of unexplained cardiac pain. JAMA 1979;241:2793–7.
Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth 2008;100:165–83.
Lee LA, Roth S, Posner KL, Cheney FW, Caplan RA, Newman NJ, et al. The American society of anesthesiologists postoperative visual loss registry: Analysis of 93 spine surgery cases with postoperative visual loss. Anesthesiology 2006;105:652–9.
Chang SH, Miller NR. The incidence of vision loss due to perioperative ischemic optic neuropathy associated with spine surgery: The Johns Hopkins hospital experience. Spine (Phila Pa 1976) 2005;30:1299–302.
Tetzlaff JE, Dilger JA, Kodsy M, al-Bataineh J, Yoon HJ, Bell GR, et al. Spinal anesthesia for elective lumbar spine surgery. J Clin Anesth 1998;10:666–9.
Sinha A, Agarwal A, Gaur A, Pandey CK. Oropharyngeal swelling and macroglossia after cervical spine surgery in the prone position. J Neurosurg Anesthesiol 2001;13:237–9.
Stochkendahl MJ, Christensen HW. Chest pain in focal musculoskeletal disorders. Med Clin North Am 2010;94:259–73.
Aeschlimann A, Kahn MF. Tietze’s syndrome: A critical review. Clin Exp Rheumatol 1990;8:407–12.
Volterrani L, Mazzei MA, Giordano N, Nuti R, Galeazzi M, Fioravanti A, et al. Magnetic resonance imaging in Tietze’s syndrome. Clin Exp Rheumatol 2008;26:848–53.
Gijsbers E, Knaap SF. Clinical presentation and chiropractic treatment of tietze syndrome: A 34-year-old female with left-sided chest pain. J Chiropr Med 2011;10:60–3.
Koç ZP, Balci TA, Ozyurtkan MO. The role of the three phase bone scintigraphy in the management of the patients with costochondral pain. Mol Imaging Radionucl Ther 2013;22:90–3.
Edelstein G, Levitt RG, Slaker DP, Murphy WA. Computed tomography of Tietze syndrome. J Comput Assist Tomogr 1984;8:20–3.
De Filippo M, Albini A, Castaldi V, Monaco D, Sverzellati N. Carbognani P, Rusca M, Rindi G, Zompatori M. MRI findings of Tietze’s syndrome mimicking mediastinal malignancy on MDCT. European Journal of Radiology Extra, 65, 33–35. https://doi.org/10.1016/J.EJREX.2007.10.006.
Carabasi RJ, Christian JJ, Brindley HH. Costosternal chondrodynia: A variant of Tietze’s syndrome? Dis Chest 1962;41:559–62.
van Schalkwyk AJ, van Wingerden JJ. A variant of Tietze’s syndrome occurring after reconstructive breast surgery. Aesthetic Plast Surg 1998;22:430–2.
Matthews JC. Chest pseudoangina due to costal chondrodynia. Tietze’s syndrome. Prensa Med Argent 1963;50:3006–10.
Shambrom E, Feher A. Tietze’s syndrome; report of a case with involvement of the cricoarytenoid joint. AMA Arch Intern Med 1955;96:697–9.
Valesova M, Hanus J. Tietze’s syndrome as a manifestation of the metastasis of Grawitz’s adenocarcinoma. Fysiatr Revmatol Vestn 1984;62:88–90.
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Kumar, V.A., Babu, J.N. Refractory Tietze’s Syndrome Occurring after Lumbar Spine Surgery in Prone Position. JOIO 53, 574–577 (2019). https://doi.org/10.4103/ortho.IJOrtho_276_18
- Chest wall insult
- positional complication
- prone position
- Tietze’s syndrome