Scoliosis after pectus excavatum correction

Does it improve or worsen

Jae Ho Chung, Hyung Joo Park, Kwang Taik Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVES: Scoliosis is associated with pectus excavatum. However, the change in the degree of scoliosis after pectus excavatum correction has not been clarified. This study examined how the correction of pectus excavatum influences the status of pre-existing scoliosis. METHODS: A total of 779 pectus excavatum patients operated between 2007 and 2011 using the pectus bar were retrospectively analysed. Preoperative severity and postoperative change of scoliosis in accordance with the severity of pectus excavatum were evaluated. Cobb angle, Haller index and sternal tilt degree were measured from pre- and postoperative whole-spine anteroposterior radiographs and chest computed tomography. RESULTS: Sixty-three (8%) patients had scoliosis (Cobb angle > 10°). No significant correlation was noted between postoperative changes in Cobb angle, Haller index or sternal tilt angle. Preoperative severity of scoliosis showed a positive correlation with postoperative changes in Cobb angle (r = 0.527, P < 0.001). In analyses between groups with mild and moderate scoliosis (Cobb angle < 15° and > 15°, respectively), the mean postoperative Cobb angle was decreased in mild scoliosis (-2.88°) but was increased in moderate scoliosis (3.86° P < 0.001). Regarding the 'improvement' and 'aggravation' of scoliosis after pectus correction, preoperative severity of scoliosis was the only significant factor in univariable and multivariable analysis. CONCLUSIONS: Pectus excavatum repair using a pectus bar may improve scoliosis, but when the preoperative Cobb angle exceeds 15°, scoliosis may be aggravated. Therefore, pectus excavatum with concomitant moderate scoliosis requires extra caution during repair. This preliminary result suggests further investigation into the effect of chest cage remodelling on spine dynamics.

Original languageEnglish
Pages (from-to)76-82
Number of pages7
JournalEuropean Journal of Cardio-thoracic Surgery
Volume52
Issue number1
DOIs
Publication statusPublished - 2017 Jul 1

Fingerprint

Funnel Chest
Scoliosis
Spine
Thorax

Keywords

  • Pectus excavatum
  • Pectus excavatum repair
  • Scoliosis

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Scoliosis after pectus excavatum correction : Does it improve or worsen. / Chung, Jae Ho; Park, Hyung Joo; Kim, Kwang Taik.

In: European Journal of Cardio-thoracic Surgery, Vol. 52, No. 1, 01.07.2017, p. 76-82.

Research output: Contribution to journalArticle

@article{e79bdb95fe5741809af59588752809bc,
title = "Scoliosis after pectus excavatum correction: Does it improve or worsen",
abstract = "OBJECTIVES: Scoliosis is associated with pectus excavatum. However, the change in the degree of scoliosis after pectus excavatum correction has not been clarified. This study examined how the correction of pectus excavatum influences the status of pre-existing scoliosis. METHODS: A total of 779 pectus excavatum patients operated between 2007 and 2011 using the pectus bar were retrospectively analysed. Preoperative severity and postoperative change of scoliosis in accordance with the severity of pectus excavatum were evaluated. Cobb angle, Haller index and sternal tilt degree were measured from pre- and postoperative whole-spine anteroposterior radiographs and chest computed tomography. RESULTS: Sixty-three (8{\%}) patients had scoliosis (Cobb angle > 10°). No significant correlation was noted between postoperative changes in Cobb angle, Haller index or sternal tilt angle. Preoperative severity of scoliosis showed a positive correlation with postoperative changes in Cobb angle (r = 0.527, P < 0.001). In analyses between groups with mild and moderate scoliosis (Cobb angle < 15° and > 15°, respectively), the mean postoperative Cobb angle was decreased in mild scoliosis (-2.88°) but was increased in moderate scoliosis (3.86° P < 0.001). Regarding the 'improvement' and 'aggravation' of scoliosis after pectus correction, preoperative severity of scoliosis was the only significant factor in univariable and multivariable analysis. CONCLUSIONS: Pectus excavatum repair using a pectus bar may improve scoliosis, but when the preoperative Cobb angle exceeds 15°, scoliosis may be aggravated. Therefore, pectus excavatum with concomitant moderate scoliosis requires extra caution during repair. This preliminary result suggests further investigation into the effect of chest cage remodelling on spine dynamics.",
keywords = "Pectus excavatum, Pectus excavatum repair, Scoliosis",
author = "Chung, {Jae Ho} and Park, {Hyung Joo} and Kim, {Kwang Taik}",
year = "2017",
month = "7",
day = "1",
doi = "10.1093/ejcts/ezx041",
language = "English",
volume = "52",
pages = "76--82",
journal = "European Journal of Cardio-thoracic Surgery",
issn = "1010-7940",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Scoliosis after pectus excavatum correction

T2 - Does it improve or worsen

AU - Chung, Jae Ho

AU - Park, Hyung Joo

AU - Kim, Kwang Taik

PY - 2017/7/1

Y1 - 2017/7/1

N2 - OBJECTIVES: Scoliosis is associated with pectus excavatum. However, the change in the degree of scoliosis after pectus excavatum correction has not been clarified. This study examined how the correction of pectus excavatum influences the status of pre-existing scoliosis. METHODS: A total of 779 pectus excavatum patients operated between 2007 and 2011 using the pectus bar were retrospectively analysed. Preoperative severity and postoperative change of scoliosis in accordance with the severity of pectus excavatum were evaluated. Cobb angle, Haller index and sternal tilt degree were measured from pre- and postoperative whole-spine anteroposterior radiographs and chest computed tomography. RESULTS: Sixty-three (8%) patients had scoliosis (Cobb angle > 10°). No significant correlation was noted between postoperative changes in Cobb angle, Haller index or sternal tilt angle. Preoperative severity of scoliosis showed a positive correlation with postoperative changes in Cobb angle (r = 0.527, P < 0.001). In analyses between groups with mild and moderate scoliosis (Cobb angle < 15° and > 15°, respectively), the mean postoperative Cobb angle was decreased in mild scoliosis (-2.88°) but was increased in moderate scoliosis (3.86° P < 0.001). Regarding the 'improvement' and 'aggravation' of scoliosis after pectus correction, preoperative severity of scoliosis was the only significant factor in univariable and multivariable analysis. CONCLUSIONS: Pectus excavatum repair using a pectus bar may improve scoliosis, but when the preoperative Cobb angle exceeds 15°, scoliosis may be aggravated. Therefore, pectus excavatum with concomitant moderate scoliosis requires extra caution during repair. This preliminary result suggests further investigation into the effect of chest cage remodelling on spine dynamics.

AB - OBJECTIVES: Scoliosis is associated with pectus excavatum. However, the change in the degree of scoliosis after pectus excavatum correction has not been clarified. This study examined how the correction of pectus excavatum influences the status of pre-existing scoliosis. METHODS: A total of 779 pectus excavatum patients operated between 2007 and 2011 using the pectus bar were retrospectively analysed. Preoperative severity and postoperative change of scoliosis in accordance with the severity of pectus excavatum were evaluated. Cobb angle, Haller index and sternal tilt degree were measured from pre- and postoperative whole-spine anteroposterior radiographs and chest computed tomography. RESULTS: Sixty-three (8%) patients had scoliosis (Cobb angle > 10°). No significant correlation was noted between postoperative changes in Cobb angle, Haller index or sternal tilt angle. Preoperative severity of scoliosis showed a positive correlation with postoperative changes in Cobb angle (r = 0.527, P < 0.001). In analyses between groups with mild and moderate scoliosis (Cobb angle < 15° and > 15°, respectively), the mean postoperative Cobb angle was decreased in mild scoliosis (-2.88°) but was increased in moderate scoliosis (3.86° P < 0.001). Regarding the 'improvement' and 'aggravation' of scoliosis after pectus correction, preoperative severity of scoliosis was the only significant factor in univariable and multivariable analysis. CONCLUSIONS: Pectus excavatum repair using a pectus bar may improve scoliosis, but when the preoperative Cobb angle exceeds 15°, scoliosis may be aggravated. Therefore, pectus excavatum with concomitant moderate scoliosis requires extra caution during repair. This preliminary result suggests further investigation into the effect of chest cage remodelling on spine dynamics.

KW - Pectus excavatum

KW - Pectus excavatum repair

KW - Scoliosis

UR - http://www.scopus.com/inward/record.url?scp=85021732429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85021732429&partnerID=8YFLogxK

U2 - 10.1093/ejcts/ezx041

DO - 10.1093/ejcts/ezx041

M3 - Article

VL - 52

SP - 76

EP - 82

JO - European Journal of Cardio-thoracic Surgery

JF - European Journal of Cardio-thoracic Surgery

SN - 1010-7940

IS - 1

ER -