Rationale: Nuss procedure is a safe and popular minimally invasive surgical technique for the correction of pectus excavatum in adolescents. Acquired scoliosis over 50 degrees after Nuss procedure has never been reported.
Patient concerns: A 14-year-old boy was referred to pediatric surgery for pectus excavatum deformity. He underwent a successful Nuss procedure. At follow up, the patient was noted having an asymmetric back whole spine X-ray showed a right-sided thoracic curve with a Cobb angle of 54 degrees.
Interventions and outcomes: We obtained a satisfactory result by removing the pectus bar and prescribing the patient a brace.
Lessons: This report demonstrates that the spine should be evaluated routinely before and after Nuss procedure. Besides, spinal fusion is not recommended for acquired scoliosis following pectus excavatum surgery.