Scoliosis after median sternotomy in children with congenital heart disease.
METHODS
A retrospective review of spinal deformity in patients with congenital heart disease surgically treated through a median sternotomy before the age of 8 years. Assessment was done on chest roentgenograms at skeletal maturity.


OBJECTIVE
To determine if patients surgically treated through a median sternotomy present a higher prevalence of spinal deformity.


BACKGROUND
Congenital heart disease is associated with a higher prevalence of scoliosis. The etiology of scoliosis in this group of patients is unknown. Thoracotomy causes scoliosis, but median sternotomy has not been identified as a causal agent in these patients.


METHODS
Chest roentgenograms were done after skeletal maturity in 128 patients to assess for the presence of a spinal deformity in the sagittal or coronal plane as a result of a median sternotomy for treatment of congenital heart disease before the age of 8 years in patients without any prior radiographic evidence of spinal or costal deformity before surgery.


RESULTS
Forty-four (34.3%) of these patients had scoliosis greater than 10 degrees , 16 of them (12.5%) had curves greater than 20 degrees , and 33 (25.8%) had thoracic kyphosis lesser than 20 degrees . Patients operated before the age of 18 months had a significantly increased risk of developing scoliosis than those operated at a later age (odds ratio = 3.5; confidence interval = 1.3-9.6; P = 0.016). The presence of scoliosis was not related to the type of congenital heart disease.


CONCLUSIONS
There is a high prevalence of scoliosis in patients with congenital heart disease surgically treated through a median sternotomy. The prevalence of scoliosis increases in patients operated at an earlier age.
Ruiz-Iban
Miguel A
MA
Departamento de Cirugía Ortopédica y Traumatología, Hospital Ramón y Cajal, Madrid, Spain. drmri@hotmail.com
Burgos
Jesus
J
Aguado
Hector J
HJ
Diaz-Heredia
Jorge
J
Roger
Ignacio
I
Muriel
Alfonso
A
Sanchez
Pedro A
PA
D000293:Adolescent; D000328:Adult; D000375:Aging; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D008297:Male; D015995:Prevalence; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D013249:Sternum / Q000601:surgery*