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Childhood Esophageal Atresia Linked to Adult Scoliosis

Higher risk of scoliosis seen compared to general population; nearly half had vertebral anomalies

THURSDAY, Nov. 12 (HealthDay News) -- Adults with a history of esophageal atresia repair during infancy face a substantially higher risk of scoliosis, according to research published online Nov. 9 in Pediatrics.

Saara J. Sistonen, M.D., of the Helsinki University Central Hospital in Finland, and colleagues analyzed data from 100 adults surgically treated for esophageal atresia during infancy. All underwent physical and radiographic examination.

The researchers found that 56 subjects had scoliosis greater than 10 degrees, and 11 had scoliosis greater than 20 degrees. The risk of scoliosis greater than 10 degrees was 13 times higher in these subjects than the general population. Furthermore, 45 patients had vertebral anomalies, typically in the cervical spine. Having additional physical anomalies -- such as limb anomalies or the combination known as VACTERL -- was associated with a higher risk of vertebral anomalies.

"The risk of scoliosis is 13-fold after repair of esophageal atresia in relation to the general population. Nearly half of the patients have vertebral anomalies which predominate in the cervical spine. Most of these anomalies were not diagnosed during initial treatment period or during growth. Spinal surgery is rarely indicated. Although the natural history of spinal deformities in patients with esophageal atresia seems rather benign, clinical screening of scoliosis at the time of prepubertal growth spurt may be justified," the authors conclude.

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