ABSTRACT
Objectives:
To evaluate the prevalence of scoliosis and kyphosis development in patients who have been treated surgically with medial sternotomy or left thoracotomy due to congenital heart anomalies.
Patients and Methods:
170 patients treated with surgery due to congenital heart diseases (CHDs) between 1987 and 2009 were included in this study. 102 of the patients were female (60%) and 68 were male (40%). The CHDs were grouped as cyanotic (149 patients, 87.6%) and acyanotic (21 patients, 12.4%). The number of the patients who were operated on before the age of 5 was 131 (77%), and the number over the age of 5 was 39 (23%). Sternotomy was applied to 158 patients, and the other 12 received left thoracotomy. The measurements were made using the Cobb technique, using standing PA and lateral chest X-rays taken during routine follow-up. The kyphosis angle was measured separately on the lateral thoracic X-rays at two levels, one between T2 and T5, and the other between T5 and T12.
Results:
We detected scoliosis in 25.2% of the patients (43 out of 170). While the Cobb measurements were between 10 to 20 degrees in 86% of the cases, the rest (14%) were over 20 degrees. It was found that there was no statistical significance with regards to the scoliosis progression between the sternotomy and thoracotomy patients (p=0.161). The average kyphosis angle was found to be 32.92° in the sternotomy patients, and 29.67° in the thoracotomy patients. The average T2–5 kyphosis was 14.5° and the average T5–12 kyphosis was 16.2°. There were no statistically significant differences between the thoracotomy and sternotomy patients with regard to scoliosis progression (p=0.532 and p=0.107). The T2–5 kyphosis angles of the scoliosis patients were found to be considerably lower when compared to patients without scoliosis. The scoliosis prevalence rate was found to be increased by 8.42-fold in children operated on under the age of 5 with respect to those operated on over the age of 5. There were no statistically significant differences in whether the heart disease was cyanotic or acyanotic with respect to scoliosis or kyphosis progression (p=0.362, p=0.586, p=0.184).
Conclusion:
The scoliosis prevalence rate is found to be increased in patients treated with either sternotomy or thoracotomy due to CHD, and the T2–5 kyphosis is also found to be increased compared to the normal population. These spinal deformities are more commonly observed in children operated on under the age of 5.
