Musculoskeletal deformities after thoracic surgery in children: an observational long-term follow-up study
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In brief
In brief
Long-term follow-up of 104 pediatric thoracic surgery patients reveals 39% develop musculoskeletal deformities including scapular winging, scoliosis, and chest wall anomalies, though most are subclinical with only 8% requiring intervention. Serratus anterior muscle division during thoracotomy is the strongest predictor of deformity development, supporting adoption of muscle-sparing surgical techniques.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study reports the incidence, severity, and predictors of musculoskeletal deformities (MD), including scoliosis and chest wall anomalies, following thoracic procedures in children.
Methods
Children younger than 14 years who had thoracic surgery between 1997 and 2012 and had no other predispositions to MD, underwent longitudinal follow-ups with dedicated musculoskeletal examination performed in an esophageal atresia, orthopedic, or research clinic. Incidence of MD was calculated, and logistic regression methods were used to determine independent predictors, including sex, gestational age, age at procedure, serratus anterior muscle division, and chest tube placement.
Results
The study cohort consisted of 104 patients followed for a median of 10.8 years (range 3–21). A total of 56 MD developed in 41 patients (39%), including scapular winging (24; 23%), scoliosis (17; 16%), and chest wall anomalies (15; 14%). The majority of MD were subclinical, with only 8 patients [8% (6 thoracotomies, 2 thoracoscopies)] requiring intervention. Among patients who underwent thoracotomies (93, 89%), serratus anterior muscle division was the only significant predictor of the development of MD [OR 8.9; 95% CI 2.8–32.6].
Conclusion
Musculoskeletal deformities develop in a significant proportion of children following thoracic surgery, but most are subclinical. A muscle-sparing technique decreases the incidence of these deformities.
Type of Study
Prospective Cohort Study.
Level of Evidence
Level II.