• Miguel A Ruiz-Iban, Jesus Burgos, Hector J Aguado, Jorge Diaz-Heredia, Ignacio Roger, Alfonso Muriel, and Pedro A Sanchez.
• Departamento de Cirugía Ortopédica y Traumatología, Hospital Ramón y Cajal, Madrid, Spain. drmri@hotmail.com
• Spine. 2005 Apr 15; 30 (8): E214-8.

Study DesignA 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.ObjectivesTo determine if patients surgically treated through a median sternotomy present a higher prevalence of spinal deformity.Summary Of Background DataCongenital 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.MethodsChest 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.ResultsForty-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.ConclusionsThere 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.

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