Natural History of Spinal Anomalies and Scoliosis Associated With Esophageal Atresia

Sistonen, Saara J.; Helenius, Ilkka; Peltonen, Jari; Sarna, Seppo; Rintala, Risto; Pakarinen, Mikko P.

doi:10.1542/peds.2008-3704

Cited by 46 publications

(30 citation statements)

References 33 publications

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“…Barnes, in a series of large curves with Cobb angles ranging from 41 to 140°, failed to demonstrate a difference between rib resection plus bracing vs bracing alone in progressive infantile scoliosis, suggesting that rib resection did not prove to be an efficient treatment strategy for scoliosis [28]. The risk of scoliosis after repair of esophageal atresia is 13-fold higher compared to the general population; however, many of these patients have vertebral anomalies that confound the cause of the scoliosis [29]. Scoliosis after treatment of esophageal atresia or tracheoesophageal fistula tends to be concave toward the side of the chest incision, often as a result of rib fusion [16,18,19,29].…”

Section: Discussionmentioning

confidence: 99%

Scoliosis after chest wall resection

Glotzbecker

Gold

Puder

et al. 2013

Journal of Children's Orthopaedics

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Background data There has been an increased focus on the role of rib abnormalities in the development of scoliosis. Rib resection may influence the development of scoliosis. Although scoliosis has been identified in patients after thoracotomy, most of the currently available information is from case reports. Methods We examined records of 37 patients who underwent a chest wall or rib resection for rib lesions at our institution during the period of 1992 to 2005. Adequate data was available in 21 patients. We gathered data on demographic information, location of resection, and changes in curvature after resection based on radiograph or scout CT films at the latest follow-up appointment.

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Section: Discussionmentioning

confidence: 99%

Scoliosis after chest wall resection

Glotzbecker

Gold

Puder

et al. 2013

Journal of Children's Orthopaedics

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“…Shoulder asymmetry, as a long term complication of surgery, is seen in as many as 80% of cases [10], and rib blocks at the site of thoracotomy are present in 30% [11]. These abnormalities are most probably connected with thoracotomy and congenital vertebral and rib anomalies [10][11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…These abnormalities are most probably connected with thoracotomy and congenital vertebral and rib anomalies [10][11][12][13][14]. All of our patients were operated via posterolateral thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

“…The presence [12,15]. This deformation is usually mild, not requiring operative treatment [10,11]. Risk factors for scoliosis include: narrowing of intervertebral spaces, ribs blocks and congenital vertebral anomalies [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…This deformation is usually mild, not requiring operative treatment [10,11]. Risk factors for scoliosis include: narrowing of intervertebral spaces, ribs blocks and congenital vertebral anomalies [10][11][12][13]. It has been demonstrated that in 41.5% of patients with congenital vertebral deformations scoliosis develops [13].…”

Section: Discussionmentioning

confidence: 99%

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Long-term complications of congenital esophageal atresia–single institution experience

et al. 2015

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Objective: To evaluate general health condition of children operated for esophageal atresia, including complications from gastrointestinal tract and skeletal defects. Methods:Between 1990 and 2005, 77 patients were operated for esophageal atresia in the Polish Mother's Health Memorial Hospital. The study was based on retrospective analysis of medical case records of all children with esophageal atresia. All living patients (n=51) were invited for follow-up studies.Results: Pathological gastroesophageal reflux was found in 46.7% of children. Scoliosis was diagnosed in 20 patients. Chest deformations were observed in 43.3% children Conclusion:The absence of clinical symptoms does not exclude the presence of gastroesophageal reflux in children operated for esophageal atresia. Children operated for esophageal atresia should be followed up regularly by a multispecialistic medical team.

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Retrospective analysis of neurological findings in esophageal atresia: Allostatic load of disease complexity, cumulative sedation, and anesthesia exposure

McMahon,

Evanovich,

Pier

et al. 2023

Birth Defects Research

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BackgroundThere is limited knowledge regarding the impact of perioperative critical care on frequency of neurological imaging findings following esophageal atresia (EA) repair.MethodsThis is a retrospective study of infants (n = 70) following EA repair at a single institution (2009–2020). Sex, gestational age at birth, type of surgical repair, underlying disease severity, and frequency of neurologic imaging findings were obtained. We quantified the length of postoperative pain/sedation treatment and anesthesia exposure in the first year of life. Data were presented as numerical sums and percentages, while associations were measured using Spearman's Rho.ResultsVertebral/spinal cord imaging was performed in all infants revealing abnormalities in 44% (31/70). Cranial/brain imaging findings were identified in 67% (22/33) of infants in the context of clinically indicated imaging (47%; 33/70). Long‐gap EA patients (n = 16) received 10 times longer postoperative pain/sedation treatment and twice the anesthesia exposure compared with short‐gap EA patients (n = 54). The frequency of neurologic imaging findings did not correlate with underlying disease severity scores, length of pain/sedation treatment, or cumulative anesthesia exposure. Lack of associations between clinical measures and imaging findings should be interpreted with caution given possible underestimation of cranial/brain findings.ConclusionsWe propose that all infants with EA undergo brain imaging in addition to routine spinal imaging given the high burden of abnormal brain/cranial findings in our cohort. Quantification of pain/sedation and anesthesia exposure in long‐gap EA patients could be used as indirect markers in future studies assessing the risk of neurological sequelae as evidenced by early abnormalities on brain imaging.

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Natural History of Spinal Anomalies and Scoliosis Associated With Esophageal Atresia

Abstract: The risk of scoliosis is 13-fold after repair of EA in relation to general population. Nearly half of the patients have vertebral anomalies predominating in the cervical spine. Most of these deformities were not diagnosed primarily or during growth. Spinal surgery is rarely indicated.

Cited by 46 publications

References 33 publications

Scoliosis after chest wall resection

Scoliosis after chest wall resection

Long-term complications of congenital esophageal atresia–single institution experience

Retrospective analysis of neurological findings in esophageal atresia: Allostatic load of disease complexity, cumulative sedation, and anesthesia exposure

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