PMID- 30229236
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2472-7245 (Electronic)
IS  - 2472-7245 (Linking)
VI  - 3
IP  - 1
DP  - 2018 Mar 29
TI  - Prevalence of and Predictive Factors for Scoliosis After Surgery for Congenital 
      Heart Disease in the First Year of Life.
PG  - e0045
LID - 10.2106/JBJS.OA.17.00045 [doi]
LID - e0045
AB  - BACKGROUND: The surgical treatment of congenital heart disease is reported to be 
      associated with a high prevalence of scoliosis, although the detailed etiology is 
      unknown. Surgical interventions involving the rib cage are considered to increase 
      the risk of scoliosis. However, whether the cardiac condition or the procedure 
      performed makes patients more susceptible to the development of spinal deformity 
      is controversial. METHODS: The present study included 483 patients who underwent 
      surgery for the treatment of congenital heart disease with use of procedures 
      involving the immature rib cage (sternotomy and/or thoracotomy) during the first 
      year of life, followed by the evaluation of standing chest radiographs at >/=10 
      years of age. Patients with congenital spinal deformity and potential 
      neuromuscular disease were excluded. The prevalence of and predictive factors for 
      scoliosis were evaluated. The presence of scoliosis (Cobb angle >/=10 degrees  to <20 degrees , 
      >/=20 degrees  to <30 degrees , >/=30 degrees  to <45 degrees , >/=45 degrees ), the convex side of the curve, and the location 
      of the curve were evaluated radiographically. Potential predictive factors that 
      were analyzed included the age at the time of surgery, surgical approach, use of 
      cardiopulmonary bypass, postoperative heart failure and/or cyanosis, New York 
      Heart Association (NYHA) class, cardiomegaly, and age at the time of radiography. 
      RESULTS: The mean age at the time of surgery was 112 days, and the mean age at 
      the time of radiography was 14.4 years. The prevalence of scoliosis was 42.4%, 
      and the prevalences of >/=10 degrees  to <20 degrees , >/=20 degrees  to <30 degrees , >/=30 degrees  to <45 degrees , and >/=45 degrees  
      scoliosis were 31.7%, 5.8%, 2.5%, and 2.5%, respectively. Three patients 
      underwent surgery for the treatment of progressive scoliosis. Multivariate 
      analysis indicated that the predictive factors were female sex, left thoracotomy, 
      bilateral thoracotomy, NYHA class, and age at the time of radiography for >/=10 degrees  
      scoliosis; cardiomegaly, NYHA class, and age at the time of radiography for >/=20 degrees  
      scoliosis; cardiomegaly, number of surgical procedures, and age at the time of 
      radiography for >/=30 degrees  scoliosis; and cardiomegaly for >/=45 degrees  scoliosis. Age at the 
      time of radiography was a predictor of <45 degrees  scoliosis; however, the relative 
      association was small. CONCLUSIONS: Surgery for the treatment of congenital heart 
      disease during the first year of life was associated with a high prevalence of 
      scoliosis (>/=40%). While female sex was one of several predictors of >/=10 degrees  
      scoliosis, cardiomegaly was the sole predictor of >/=45 degrees  scoliosis. LEVEL OF 
      EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete 
      description of levels of evidence.
FAU - Kaito, Takashi
AU  - Kaito T
AD  - Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 
      Suita, Japan.
FAU - Shimada, Masatoshi
AU  - Shimada M
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cardiovascular Center, Suita, Japan.
FAU - Ichikawa, Hajime
AU  - Ichikawa H
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cardiovascular Center, Suita, Japan.
FAU - Makino, Takahiro
AU  - Makino T
AD  - Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 
      Suita, Japan.
FAU - Takenaka, Shota
AU  - Takenaka S
AD  - Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 
      Suita, Japan.
FAU - Sakai, Yusuke
AU  - Sakai Y
AD  - Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 
      Suita, Japan.
FAU - Yoshikawa, Hideki
AU  - Yoshikawa H
AD  - Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, 
      Suita, Japan.
FAU - Hoashi, Takaya
AU  - Hoashi T
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cardiovascular Center, Suita, Japan.
LA  - eng
PT  - Journal Article
DEP - 20180312
PL  - United States
TA  - JB JS Open Access
JT  - JB & JS open access
JID - 101726219
PMC - PMC6132905
EDAT- 2018/09/20 06:00
MHDA- 2018/09/20 06:01
PMCR- 2018/03/12
CRDT- 2018/09/20 06:00
PHST- 2018/09/20 06:00 [entrez]
PHST- 2018/09/20 06:00 [pubmed]
PHST- 2018/09/20 06:01 [medline]
PHST- 2018/03/12 00:00 [pmc-release]
AID - JBJSOA-D-17-00045 [pii]
AID - 10.2106/JBJS.OA.17.00045 [doi]
PST - epublish
SO  - JB JS Open Access. 2018 Mar 12;3(1):e0045. doi: 10.2106/JBJS.OA.17.00045. 
      eCollection 2018 Mar 29.