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Thoracogenic scoliosis: coronal deformity progression in paediatric patients

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Abstract

Purpose

To assess the risk of developing thoracogenic scoliosis (THS) in paediatric patients, depending on the side of lateral thoracotomy (LT) and of spine deviation in the coronal plane by means of logistic regression and scoliosis-free survival analyses.

Methods

A total of 307 consecutive patients undergoing LT were retrospectively reviewed; 32 patients met the inclusion criteria: 1) underwent LT and developed THS; 2) age < 15 years at LT; 3) clinical and radiographic follow-up ≥ 5 years. Patients were divided into ipsilateral group (convexity ipsilateral to LT) and contralateral group (convexity contralateral to LT).

Results

The mean follow-up was 10 ± 4.7 in the ipsilateral group (n = 13) and 12 ± 4.8 years in the contralateral group (n = 19). The contralateral group underwent LT at a younger age (4.4 vs 6.4 years, p = 0.55), developed more severe coronal deformity (27.8° vs 18.9°, p = 0.15), had higher rate of THS > 20° (47.5% vs 38.4%; p = 0.34) and > 45° (21.1% vs 0%; p = 0.99). The mean time from LT to THS diagnosis was 4.2 ± 2.9 in ipsilateral group and 5.5 ± 4.2 years in contralateral group. Left-side LT (p = 0.03) and age > 5 years (p = 0.01) showed a lower risk of THS diagnosis. The group variable had a statistically significant effect on the risk of developing THS > 45° (p = 0.03).

Conclusion

In this series, children that developed THS with a convexity contralateral to the side of LT had more severe and progressive coronal spine deformity.

Level of evidence:

III

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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. CHU de Rouen, Department of Orthopedic Surgery, 76000, Rouen, France

    Riccardo Sacco, Mourad Ould-Slimane & Franck Dujardin

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

    Michel Bonnevalle

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

    Eric Nectoux & Federico Canavese

  4. CHU de Rouen, Department of Biostatistics, 76000, Rouen, France

    Alessandra Zago

Authors
  1. Riccardo Sacco
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  2. Mourad Ould-Slimane
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  3. Michel Bonnevalle
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  4. Eric Nectoux
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  5. Alessandra Zago
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  6. Franck Dujardin
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  7. Federico Canavese
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Contributions

All authors contributed to the study conception and design. Manuscript preparation, data collection and analysis were performed by RS and FC. 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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This study was approved by the Ethics Committee of the Jeanne de Flandre Hospital of Lille.

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Sacco, R., Ould-Slimane, M., Bonnevalle, M. et al. Thoracogenic scoliosis: coronal deformity progression in paediatric patients. Eur Spine J 32, 639–650 (2023). https://doi.org/10.1007/s00586-022-07498-z

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  • DOI: https://doi.org/10.1007/s00586-022-07498-z

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