A retrospective study of congenital scoliosis and associated cardiac and intraspinal abnormities in a Chinese population

Abstract

Our objective is to assess the incidence of cardiac and intraspinal abnormities in Chinese congenital scoliosis (CS) patients and to study the relationship between the associated abnormities and the different CS types. Fivehundred and thirty-nine consecutive Chinese patients with CS were retrospectively studied, and the records of echocardiography, plain radiograph of the entire spine, magnetic resonance imaging of the entire spine and/or myelogram were reviewed. The results indicated that the incidence of cardiac and intraspinal abnormities in CS patients was 14.1 and 24.5%, respectively. There was no difference in the incidence of associated cardiac and intraspinal abnormities in different CS types (P [ 0.05). The most common cardiac abnormities in CS patients was mitral valve prolapse, which was followed by congenital heart diseases, including atrial septal defect, ventricular septal defect, bicuspid aortic valve and patent ductus ateriosus. The cardiac abnormities were not likely to be concurrent with intraspinal abnormities in CS patients (P = 0.04). The intraspinal abnormities were more common in female and older patients (all P \ 0.05). One or more abnormities mentioned above could be found in 36.8% CS patients and were more likely to be found in female patients (P \ 0.01). We concluded that CS is not a simple abnormity, due to the high incidence of associated deformities of other organs, comprehensive assessment was strongly recommended before the surgical correction for CS patients.

Congenital cardiac anomalies in myelomeningocele patients

“…Our study was unable to show any significant relationship between MMC location and heart anomalies either. In this study, skeletal abnormalities involving the ribs and vertebral column (associated with spinal curvature deformity) were found in both MMC children with congenital heart anomalies, while other authors did not mention this association (1,(9)(10)(11).The detection of cardiac anomalies prior to surgery is important to support the child by giving special care during anesthesia and the operation, and prevent perioperative life threatening complications, such as air emboli or endocarditis.…”

“…Apart from ASD, most congenital cardiac anomalies are detected in early childhood (6). Congenital heart defects in MMC patients have been observed more frequently in association with skeletal malformations, including scoliosis, hemivertebrae, multiple rib anomalies and chest wall asymmetry (7)(8)(9).…”

Percutaneous Intervention in Kyphoscoliosis—Tackling a Tortuosity*

“…It has wide-ranging implications with respect to cardiovascular pathology. This includes a higher prevalence of congenital heart disease, mitral valve prolapse syndrome, pulmonary hypertension secondary to the chest wall deformity, and low lung-ventilation volumes [1]. However, the technical aspects of coronary intervention in kyphoscoliotic patients have not been reported previously.…”

“…Surface electrocardiogram can be unreliable in these patients and echocardiography is the preferred tool for pre-operative screening [4] which again may be impeded by suboptimal acoustic windows. Lung function is commonly impaired, [5] [6] but cardiac function is found to be within normal limits in the majority of patients [1]. While a literature search could not find any information specific to abnormalities in cardiac position in scoliosis, it seems a fair proposition that the heart should occupy more of the hemithorax with less compromised volume, which in most cases is ipsilateral to a concavity in the vertebral column.…”

“…Severe spine deformities pose certain challenges to the interventionalist due to the distorted chest wall and cardiac malposition [1]. Percutaneous coronary intervention in such patients with kyphoscoliosis is rarely reported.…”