Left congenital diaphragmatic hernia-associated musculoskeletal deformities

Aydın, Emrah; Özler, Oğuz; Burns, Patricia; Lim, Foong‐Yen; Peiró, José Luis

doi:10.1007/s00383-019-04548-4

Cited by 20 publications

(9 citation statements)

References 14 publications

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“…The common musculoskeletal abnormalities were reported to be the pectus excavatum in 20% of CDH survivors and scoliosis in 30% of CDH survivors [ 44 ]. Thoracic deformities (36%) were diagnosed most often after patch repair, especially when ECMO was needed (60%) [ 45 ]. In our study, 16.1% of CDH survivors were diagnosed with a thoracic deformity up to 1.5 years, 18.2% at 3 years, 19.0% at 6 years, and 27.4% at 12 years.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan

et al. 2022

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Background: Treatment modalities for neonates with congenital diaphragmatic hernia (CDH) have greatly improved in recent years, with a concomitant increase in survival. However, long-term outcomes restrict the identification of optimal care pathways for CDH survivors in adolescence and adulthood. Therefore, we evaluated the long-term outcomes within the Japanese CDH Study Group (JCDHSG). Methods: Participants were born with CDH between 2006 and 2018 according to the JCDHSG. Participants were enrolled in the database at 1.5, 3, 6, and 12 years old. Follow-up items included long-term complications, operations for long-term complication, and home medical care. Results: A total of 747 patients were included in this study, with 626 survivors (83.8%) and 121 non-survivors (16.2%). At 1.5, 3, 6, and 12 years old, 45.4%, 36.5%, 34.8%, and 43.6% developed complications, and 20.1%, 14.7%, 11.5%, and 5.1% of participants required home care, respectively. Recurrence, pneumonia, pneumothorax, gastroesophageal reflux disease, and intestinal obstruction decreased with age, and thoracic deformity increased with age. Conclusions: As CDH survival rates improve, there is a need for continued research and fine-tuning of long-term care to optimize appropriate surveillance and long-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan

et al. 2022

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“…In accordance with all findings, the fetus should be hemodynamically stable before the operation. Moreover, even with the improvements in surgical interventions and treatment strategies leading to an increase in survival rates, morbidity and extrapulmonary complications such as recurrence of the hernia, pulmonary hypoplasia, neurodevelopmental delay, and musculoskeletal abnormalities can affect the long-term outcome of severe CDH cases [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

The Survivorship Bias in Congenital Diaphragmatic Hernia

et al. 2022

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Current literature for congenital diaphragmatic hernia (CDH) focuses on the comparison of the overall mortality in CDH patients. Only a few studies concentrate on analyzing the unstable patients who could not achieve surgical repair, as well as those who could but did not survive after. Hence, this study aimed to analyze the effects of various parameters on the timing of death. A retrospective analysis was performed by using the data of all CDH patients from 2003 to 2016 at a single tertiary center. Patients who were diagnosed with left-sided CDH and expired were included in the study regardless of the cause. Of the 66 expired patients, 5 were excluded due to right-sided CDH. The study population constituted a total of 61 patients, of which 31 patients expired prior to CDH repair, and 30 patients expired at different times after CDH repair. Multinomial regression analysis identified that the ECMO need (B = 20.257, p = 0.000, OR: 62.756, 95% CI 10.600–371.384) and O/E LHR (B = 20.376, p = 0.000, OR: 70.663, 95% CI 48.716–102.415) values were the independent predictors that influenced mortality in this cohort. Prenatal pulmonary measurements are the major predictors determining the severity of the disease in patients with CDH.

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“…The progressive weakness of trunk/back muscles while vertebral column continues to grow against gravity, leads to development of scoliosis, pelvic obliquity and hip subluxation [ 36 , 37 ]. More than 90% of children with type I or type II SMA will develop scoliosis [ 38 ]. The development of scoliosis involving thoracolumbar curve further limits the expansion of chest cavity during respiratory movements.…”

Section: Eos Aetiology and Classificationmentioning

confidence: 99%

Effects of spinal deformities on lung development in children: a review

Wang

Zhang

et al. 2023

J Orthop Surg Res

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Scoliosis before the age of 5 years is referred to as early-onset scoliosis (EOS). While causes may vary, EOS can potentially affect respiratory function and lung development as children grow. Moreover, scoliosis can lead to thoracic insufficiency syndrome when aggravated or left untreated. Therefore, spinal thoracic deformities often require intervention in early childhood, and solving these problems requires new methods that include the means for both deformity correction and growth maintenance. Therapeutic strategies for preserving the growing spine and thorax include growth rods, vertically expandable titanium artificial ribs, MAGEC rods, braces and casts. The goals of any growth-promoting surgical strategy are to alter the natural history of cardiorespiratory development, limit the progression of underlying spondylarthrosis deformities and minimize negative changes in spondylothorax biomechanics due to the instrumental action of the implant. This review further elucidates EOS in terms of its aetiology, pathogenesis, pathology and treatment.

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Left congenital diaphragmatic hernia-associated musculoskeletal deformities

Cited by 20 publications

References 14 publications

Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan

Long-Term Outcomes of Congenital Diaphragmatic Hernia: Report of a Multicenter Study in Japan

The Survivorship Bias in Congenital Diaphragmatic Hernia

Effects of spinal deformities on lung development in children: a review

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