Prevalence and natural history of scoliosis and associated congenital vertebral anomalies in patients operated for esophageal atresia with or without tracheoesophageal fistula

J Pediatr Surg. 2019 Jul;54(7):1308-1311. doi: 10.1016/j.jpedsurg.2018.08.049. Epub 2018 Sep 9.

Abstract

Background: Scoliosis has been reported after repair of esophageal atresia with or without tracheoesophageal fistula (EA-TEF). This study aims to investigate the prevalence and natural history of scoliosis and associated congenital vertebral anomalies in patients operated for EATEF.

Methods: A retrospective review of patients operated for EA-TEF with radiological examination for the presence of scoliosis or associated spine congenital anomalies was done on 106 patients (ages 5-19 years).

Results: Scoliosis was found in 53 patients (49%) for which 46 of these were in the thoracic region and 33 were right-thoracic curves. After a follow-up ranging from 5 to 14 years, four patients (3.7%) out of 106 were operated for scoliosis. Right-sided thoracotomy (RST) was the identifiable risk factor for scoliosis development; all patients with scoliosis had their EA repaired through RST. Congenital vertebral anomalies were found in 8 of those patients (7.5%). After a median follow-up of 6.5 years, no patients progressed enough to require operation.

Conclusion: Scoliosis affects one of every two patients operated for EA; it may progress to the indication of surgery. RST was the identifiable risk factor for scoliosis development.

Keywords: Concavity; Congenital; Esophageal atresia; Musculoskeletal deformity; Neonatal; Pediatric; Scoliosis; Spine; Thoracotomy; Vertebral anomalies.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Esophageal Atresia / diagnostic imaging
  • Esophageal Atresia / physiopathology*
  • Esophageal Atresia / surgery
  • Female
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prevalence
  • Retrospective Studies
  • Scoliosis / diagnostic imaging
  • Scoliosis / physiopathology*
  • Scoliosis / surgery
  • Thoracotomy
  • Tracheoesophageal Fistula / diagnostic imaging
  • Tracheoesophageal Fistula / physiopathology*
  • Tracheoesophageal Fistula / surgery
  • Young Adult

Supplementary concepts

  • Esophageal atresia with or without tracheoesophageal fistula