European Spine Journal

, Volume 18, Issue 12, pp 1941–1945 | Cite as

Dextrocardia and coronal alignment of thoracic curve: a population study

  • Kaj Tallroth
  • Martina Lohman
  • Markku Heliövaara
  • Arpo Aromaa
  • Paul Knekt
  • Carl-Gustaf Standertskjöld-Nordenstam
Original Article

Abstract

The objective of this study was to evaluate the coronal alignment of the thoracic spine in persons with dextrocardia. Generally, the thoracic spine is slightly curved to the right. It has been suggested that the curve could be triggered by pulsation forces from the descending aorta. Since no population study has focused on the alignment of the thoracic spine in persons with situs inversus, dextrocardia, and right-sided descending aorta, we compared the radiographs of the thoracic spine in persons with dextrocardia to those having normal levocardia. Among 57,440 persons in a health survey, 11 cases of dextrocardia were identified through standard radiological screening. The miniature chest radiographs of eight persons were eligible for the present study. The study was carried out as a nested case–control study. Four individually matched (age, gender, and municipality) controls with levocardia were chosen for each case. Coronal alignment of the thoracic spine was analyzed without knowledge of whether the person had levo- or dextrocardia. A mild convexity to the left was found in all persons with dextrocardia and right-sided descending aorta (mean Cobb angle 6.6° to the left, SD 2.9). Of the 32 normal levocardia persons, 29 displayed a convexity to the right, and the remaining three had a straight spine (mean Cobb angle 5.2° to the right, SD 2.3). The difference (mean 11.8°, SD 3.5) differed significantly from unity (P = 0.00003). In conclusion, it seems that a slight left convexity of the thoracic spine is frequent in dextrocardia. We assume that the effect of the repetitive pulsatile pressure of the descending thoracic aorta, and the mass effect of the heart may cause the direction of the convexity to develop opposite to the side of the aortic arch.

Keywords

Situs inversus Dextrocardia Left thoracic curve Aorta 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Kaj Tallroth
    • 4
  • Martina Lohman
    • 2
  • Markku Heliövaara
    • 1
  • Arpo Aromaa
    • 1
  • Paul Knekt
    • 1
  • Carl-Gustaf Standertskjöld-Nordenstam
    • 3
  1. 1.National Public Health InstituteHelsinkiFinland
  2. 2.University of Pittsburgh Medical CenterPittsburghUSA
  3. 3.Helsinki University HospitalHelsinkiFinland
  4. 4.ORTON Research Institute, Invalid FoundationHelsinkiFinland

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