Analysis of Sternal Curvature Patterns in Patients With Pectus and Control

Abstract

Objective: To analyze reformatted sagittal sternal tomography images and classify sternal body curvature types, and compare different types of pectus populations with one another and with normal individuals. Methods: In total, 50 controls and 167 pectus patients were selected for chest CT to analyze the median sagittal plane, of whom 89 had pectus carinatum (mean age, 12 ± 10 years) and 78 pectus excavatum (mean age, 14 ± 10 years). Clinical types of pectus were classified as inferior, superior, or lateral pectus carinatum, and localized or broad pectus excavatum. The following types of sternal patterns were defined: gradual vertical curve, gradual posterior curve, gradual anterior curve, proximal third curve, middle third curve, distal third curve, anterior rectilinear, vertical rectilinear, and posterior rectilinear. Statistical analyses were performed to compare the different types of pectus with one another and with the control group. Results: Patients with different thoracic deformities, but with similar sternal curvature patterns, were observed. Some types of sternal curvature were significantly more frequent in certain types of pectus (p < 0,05). The gradual vertical curve and anterior rectilinear types prevailed in controls (p < 0,05). Conclusion: Some sternal curvature patterns were more frequent than the others in certain types of pectus and the controls. Level of Evidence II, Prognostic studies - investigating the effect of a patient characteristic on the outcome of disease.

Current Concepts in the Etiology and Pathogenesis of Pectus Excavatum in Humans—A Systematic Review

“…Recent studies hypothesize that the inward deformation of the anterior thoracic in PE may happen due to the growth disturbance of the sternum [ 115 , 116 , 117 ]. Both Haje et al (1999, 2021) and Lee at al.…”

“…Both Haje et al (1999, 2021) and Lee at al. (2017), assessed the shape of the sternum in patients with chest wall deformities versus normal [ 115 , 116 , 117 ]. They observed that the sternum in patients with PE reveal abnormal shape, posterior curvature, torsion, and sometimes relatively sudden angulation [ 117 ].…”

“…(2017), assessed the shape of the sternum in patients with chest wall deformities versus normal [ 115 , 116 , 117 ]. They observed that the sternum in patients with PE reveal abnormal shape, posterior curvature, torsion, and sometimes relatively sudden angulation [ 117 ]. Based on these findings, they concluded that the developmental disturbances of the sternum might play a role in the etiopathogenesis of chest wall deformities, including PE [ 115 , 116 , 117 ].…”

“…They observed that the sternum in patients with PE reveal abnormal shape, posterior curvature, torsion, and sometimes relatively sudden angulation [ 117 ]. Based on these findings, they concluded that the developmental disturbances of the sternum might play a role in the etiopathogenesis of chest wall deformities, including PE [ 115 , 116 , 117 ]. They and advocated for further histologic studies of the sternal growth plates [ 117 ].…”

“…Based on these findings, they concluded that the developmental disturbances of the sternum might play a role in the etiopathogenesis of chest wall deformities, including PE [ 115 , 116 , 117 ]. They and advocated for further histologic studies of the sternal growth plates [ 117 ].…”