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Thoracogenic scoliosis: a retrospective review of 129 pediatric patients with a mean follow-up of 10 years

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Abstract

Purpose

To determine the midterm outcome of lateral thoracotomy (LT) in skeletally immature patients concerning thoracogenic scoliosis development and lung parenchyma resection (LPR) extent.

Methods

In total, 129 children met the inclusion criteria: (1) LT during the study period; (2) skeletally immature at the time of LT; (3) clinical and radiographic follow-up of at least 3 years; and (4) no spinal or thoracic deformity on radiographs before LT. Patients were grouped according to their underlying disease, age at LT, and LPR extent. Radiographic parameters were assessed. Kaplan–Meier survival curves and univariate and multivariate analysis were performed.

Results

Of 129, 108 patients underwent pneumonectomy (9; 9.1%), lobectomy (79; 61.2%), segmentectomy (20; 15.5%) and 21 patients LT without LPR. The mean age at LT and at last radiological follow-up was 5.5 years (birth-17.8) and 15.2 years (3.4–33.2). The mean follow-up was 10 years (3–28.1). Scoliosis developed on average 5.3 years after LT. The mean Cobb angle was 22.1° (11–90°); > 10° in 37/129 patients (28.7%), of whom 5/129 (3.9%) had > 45°. The average vertebral rotation was 16.2° (2–43°; grade 0–II). RVAD was 26.5° (8°-33°) and 15.3° (2–43°) in patients with Cobb > 45° and ≤ 45°. Gender, age at surgery, and extent of LPR were not risk factors for post-thoracotomy scoliosis (p > 0.05), although younger patients developed a more severe deformity.

Conclusion

Although post-thoracotomy scoliosis is not associated with significant rotation, the risk of curve progression > 45° is relatively high. Regular follow-up is required as scoliosis may develop several years after LT with or without LPR.

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Acknowledgements

We would like to acknowledge the assistance of Professor Emmanuel Chazard for the statistical analysis. Université de Lille, CHU Lille, CERIM EA2694, F-59000 Lille, France.

Funding

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Department of Pediatric Orthopaedic Surgery, CHU de Lille, Jeanne de Flandre Hospital, Rue Eugène Avinée, 59000, Lille, France

    Riccardo Sacco, Eric Nectoux, Damien Fron & Federico Canavese

  2. Department of Pediatric Surgery, CHU de Lille, Jeanne de Flandre Hospital, Rue Eugène Avinée, 59000, Lille, France

    Michel Bonnevalle & Dyuti Sharma

  3. Department of Orthopaedic Surgery, CHU de Rouen, 76000, Rouen, France

    Mourad Ould-Slimane

  4. Department of Surgery and Translational Medicine, Orthopaedic Clinic, University of Florence, Florence, Italy

    Giovanni Lucchesi

Authors
  1. Riccardo Sacco
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  2. Michel Bonnevalle
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  3. Eric Nectoux
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  8. Federico Canavese
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Riccardo Sacco and Federico Canavese. The first draft of the manuscript was written by Riccardo Sacco, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Federico Canavese.

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The authors declared they have no conflict of interest.

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This study was approved by the Ethics Committee of the Jeanne de Flandre Hospital of Lille.

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Sacco, R., Bonnevalle, M., Nectoux, E. et al. Thoracogenic scoliosis: a retrospective review of 129 pediatric patients with a mean follow-up of 10 years. Eur Spine J 31, 2287–2294 (2022). https://doi.org/10.1007/s00586-022-07242-7

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