Effects of Pectus Excavatum on the Spine of Pectus Excavatum Patients with Scoliosis

Abstract

Background: There is high risk in the correction surgery of pectus excavatum with scoliosis because of the lack of the correction mechanism of pectus excavatum with scoliosis. This study performed a comprehensive analysis about the impact that pectus excavatum had on scoliosis and elaborated its biomechanical mechanism in pectus excavatum patients with scoliosis.

Methods: 37 pectus excavatum patients were selected. According to age, Haller index of pectus excavatum, offset coefficient, vertical position, sternal torsion angle, and asymmetric index, 37 patients were, respectively, divided into 2 compared groups. The result was statistically calculated.

Results: The scoliosis incidence and severity did not correlate with Haller index, offset coefficient, vertical position, sternal torsion angle, and asymmetric index of pectus excavatum, and there was no statistical significance between the two compared groups.

Conclusions: The incidence and severity of scoliosis in PE patients with scoliosis have nothing to do with the geometric parameters of pectus excavatum but correlate with age. The scoliosis will aggravate with the increase of age. The heart may provide an asymmetric horizontal force to push the spines to the right. The mechanism of how the biomechanical factors exert influences on spines needs to be further investigated to keep the spine stable.

Figures

Figure 1

Demonstration of measurements made using Mimics on computer. The Haller index is calculated by T/A and asymmetry index by R/L×100. The sternal torsion angle is marked and represents moderate degree of torsion (+24.9°). All measurements were measured at maximum distances except for A, which was measured as the minimum distance between the anterior surface of the vertebral column and the deepest portion of the sternum.

Figure 2

Demonstration of measurements using Mimics on computer. Offset coefficient calculated by A/B×100 is shown in the figure. This CT of a 12-year-old patient exhibited 57 of the offset coefficient; PE apex is on the right chest.

Figure 3

Cobb angles of the two age groups. Significant difference was found between the child and adult groups (p < 0.05).

Figure 4

Distribution of the scoliosis vertical position in 37 patients in the form of thoracic vertebra number.

Figure 5

Distribution of the PE vertical position in 37 patients in the form of thoracic vertebra number.