Abstract Marek Roclawski

Evaluation of the influence of left lateral thoracotomy on scoliosis and other postural defects in children with coarctation of the aorta
¹Marek Roclawski, ²Robert Sabiniewicz, ³Piotr Potaz, ⁴Michal Bieniecki
¹Department of Orthopaedic Surgery, Medical University of Gdansk, ²Department of Children Cardiology, Medical University of Gdansk, ³Department of Children Cardiology, Medical University of Gdansk, ⁴Department of Orthopaedic Surgery, Medical University of Gdansk (Poland)

Introduction
Surgery in the thoracic area in infancy has been implicated in the development of scoliosis of thoracogenic origin, particularly, thoracotomy is involved in the development of thoracic scoliosis.The aim of our study was: 1.To determine
if patients with coarctation of the aorta treated surgically with a left lateral thoracotomy ,present a higher prevalence of scoliosis and other postural defects. 2.To show the characteristics of thoracogenic scoliosis in order to prove the influence of lateral thoracotomy on the development of scoliosis

Material and Methods
We evaluated a group of 49 patients (16 females and 33 males ,the average age 20) from the Department of Children Cardiology of the Medical University of Gdansk. All patients were operated because of coarctation of the aorta. Left lateral thoracotomy was used as a surgical approach. We made an orthopaedic examination together with the evaluation of chest roentgenograms. We chose a group of 34 patients who had postural pathologies. In the next step an examination of their spinal deformities was done by antero-posterior and lateral spinal roentgenograms. We considered >10° of the curve as a clinical scoliosis.

Results
There was clinical scoliosis in 30 (61%) of patients. The average degree in the group with scoliosis was 15,5° The range was between 10° and 33° .24 patients (70%) had scoliosis greater than 10° . 5 of them (15%) had curves greater than 20° and 1 had 33° . There were 13 (38%) of left and 12 (35%) of right thoracic curves. Thirteen (81%) of
females and twenty-one (64%) of males had scoliosis. Additionally we found shoulder and scapular asymmetry respectively in 35 (71%) and 38 (78%) .There was a lateral deflection of the body in 30 (61%) of patients.

Conclusion
1. Prevalence of scoliosis and other postural defects was three-times higher than in the average population (61% to 20%).
2. The rate of left thoracic curves is much greater than the rate in idiopathic scoliosis (predominance of right thoracic
convexity curves).In our study, left thoracic curves accounted for 52% of all thoracic curves.
3. Female-to-male ratio in patients with coarctation of the aorta after lateral thoracotomy and scoliosis is significantly
smaller than the rate in idiopathic scoliosis.
4. There is a high incidence of scapular, shoulder asymmetry and the lateral deflection of the body, significantly greater than in the average population.
These features suggest the significant influence of lateral thoracotomy on scoliosis in our study.

Keyword(s): Scoliosis, Lateral thoracotomy, Coarctation of the aorta