Quantifying Changes in the Thoracic Wall After Nuss Bar Removal in Pectus Excavatum Patients Using 3D Imaging (CHEST)

Quantification of Thoracic Wall Changes Using Three-dimensional Optical Imaging After Nuss Bar Removal

Pectus excavatum (funnel chest) is the most common congenital anterior thoracic wall deformity. It can be associated not only with cosmetic concerns but also with psychosocial and limiting somatic complaints. Patients with this condition are often treated surgically using the Nuss bar procedure, in which a metal bar is placed behind the sternum to effectively "pop out" the funnel chest. This bar typically remains in place for 2-3 years.

To analyze how the thoracic wall changes after removal of the Nuss bar, we aim to capture three-dimensional (3D) images at four different time points: just before removal, immediately after, and at 6 and 12 months post-removal. When significant changes over time are detected, we aim to identify factors that may predict retraction or recurrence. Based on these predictive factors, individualized decision-making regarding the timing of Nuss bar removal can be optimized to minimize the risk of retraction or recurrence.

Study Overview

• Status: Completed
• Conditions: Pectus Excavatum

• Study Type: Observational
• Enrollment (Actual): 69

Contacts and Locations

Study Locations

• Netherlands
  • Heerlen, Netherlands
    • Zuyderland Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients with pectus excavatum who are visit our outpatient clinic and are scheduled for the removal of their Nuss bar.

Description

Inclusion Criteria:

• Patients of all ages and genders with a Nuss bar eligible for removal.

Exclusion Criteria:

• Patients in whom the bar or stabilizing components were dislocated
• Patients who underwent a second surgery for their pectus excavatum following the initial placement of the Nuss bar
• Patients in whom retrosternal metal bars have been placed for any indication other than the treatment of pectus excavatum
• Patients with connective tissue disorders such as Marfan syndrome
• Patients diagnosed with epilepsy
• Patients who are unable to maintain a stationary standing position for approximately 60 seconds

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Postoperative 3D scans

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
External Haller index	just before removal, immediately after, and at 6 and 12 months post-removal.

Collaborators and Investigators

• Sponsor: Erik de Loos

Study record dates

Study Major Dates

• Study Start (Actual): September 16, 2020
• Primary Completion (Actual): January 6, 2025
• Study Completion (Actual): January 6, 2025

Study Registration Dates

• First Submitted: March 23, 2026
• First Submitted That Met QC Criteria: March 23, 2026
• First Posted (Actual): March 27, 2026

Study Record Updates

• Last Update Posted (Actual): March 27, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Musculoskeletal Abnormalities; Congenital Abnormalities; Bone Diseases, Developmental; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Funnel Chest
• Other Study ID Numbers: Z2019101

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No