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Progression of infantile scoliosis after thoracotomy and sternotomy for the treatment of congenital cardiac abnormalities

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Abstract

Purpose

To determine whether the rate of progression of scoliosis is higher following thoracotomies and sternotomies in children.

Methods

We undertook a retrospective review of 1744 patients from a tertiary paediatric referral unit who had sternotomies or thoracotomies from 2005 to 2010 to identify those with scoliosis and to determine where possible, the pre- and post-operative rate of scoliosis progression. A secondary objective was to assess the risk factors for progression after surgery through Chi-square analysis.

Results

1419/1744 (81.4%) patients (55% M, 45% F) had post-op chest X-rays. 25% had a thoracotomy, and 75% had a sternotomy. 5.8% had scoliosis at their most recent chest X-ray (mean Cobb angle 20° (range 11–63°)). There was no significant difference for rates of scoliosis for those who had sternotomies vs thoracotomies (6.3% vs. 4.6% P = 0.258) but a significant difference for those who had primary vs revision sternotomies (5.1% vs. 9.9% P = 0.008). Pre- and post-op progression calculations were possible in 30 patients. The mean time from surgery to the start of the progression was 12 months (range 0–93 months). There was no significant difference between the rates of progression pre-op vs post-op: 1.0 vs. 0.5 deg/month, P = 0.228. There was no significant difference between the rates of post-op progression for those who had a sternotomy versus a thoracotomy (0.5 vs. 0.5 deg/month P = 0.503).

Conclusion

Thoracotomies and sternotomies do not appear to increase the rate of progression of scoliosis in these patients.

Level of evidence

III.

Graphical Abstract

Radiographs illustrating scoliosis progression

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Data availability

Datasets analysed in this article are available from the corresponding author if required in the future.

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Authors and Affiliations

  1. Bristol Children’s Hospital, 6 Saints Court, Pennywell Road, Bristol, BS5 0EE, UK

    Hui-Ling Kerr, Jamie O’Callaghan & Stephen Morris

Authors
  1. Hui-Ling Kerr
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  2. Jamie O’Callaghan
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  3. Stephen Morris
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Contributions

All authors contributed to the study conception and design. Idea for study conceived by [SM and L-HK]. Material preparation, data collection and analysis were performed by [H-LK and JO], the first draft of the manuscript was written by [H-LK], and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Hui-Ling Kerr.

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All appropriate ethical approval sought for this study.

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All authors whose names appear on the submission (1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; (2) drafted the work or revised it critically for important intellectual content; (3) approved the version to be published; and (4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Kerr, HL., O’Callaghan, J. & Morris, S. Progression of infantile scoliosis after thoracotomy and sternotomy for the treatment of congenital cardiac abnormalities. Spine Deform 11, 635–641 (2023). https://doi.org/10.1007/s43390-022-00633-2

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