Article

A retrospective review of spinal deformity in patients with congenital heart disease surgically treated through a median sternotomy before the age of 8 years. Assessment was done on chest roentgenograms at skeletal maturity. Objectives. To determine if patients surgically treated through a median sternotomy present a higher prevalence of spinal deformity. Summary of Background Data. Congenital heart disease is associated with a higher prevalence of scoliosis. The etiology of scoliosis in this group of patients is unknown. Thoracotomy causes scoliosis, but median sternotomy has not been identified as a causal agent in these patients. Methods. Chest roentgenograms were done after skeletal maturity in 128 patients to assess for the presence of a spinal deformity in the sagittal or coronal plane as a result of a median sternotomy for treatment of congenital heart disease before the age of 8 years in patients without any prior radiographic evidence of spinal or costal deformity before surgery. Results. Forty-four (34.3%) of these patients had scoliosis greater than 10 degrees, 16 of them (12.5%) had curves greater than 20 degrees, and 33 (25.8%) had thoracic kyphosis lesser than 20 degrees. Patients operated before the age of 18 months had a significantly increased risk of developing scoliosis than those operated at a later age ( odds ratio = 3.5; confidence interval = 1.3 - 9.6; P = 0.016). The presence of scoliosis was not related to the type of congenital heart disease. Conclusions. There is a high prevalence of scoliosis in patients with congenital heart disease surgically treated through a median sternotomy. The prevalence of scoliosis increases in patients operated at an earlier age.

Langue : ANGLAIS

Tiré à part : OUI