The Relationship Between Pectus Deformities and Spinal Pathologies
Condition: Pectus Deformity of Chest; Spinal Deformity
MeSH terms: Congenital Abnormalities
Study type: Observational

Summary: 
      Pectus deformities are common anterior chest wall pathologies. Pectus excavatum is the most
      common chest deformity with an incidence of 0.1-0.3%. Although the incidence of adolescent
      idiopathic scoliosis (AIS) is 0.2-3% in the community, some studies show that this rate rises
      to 17.61-25.58% when it is associated with pectus deformity. While the pectus excavatum
      rotates the heart to the left with its ribs and cartilages, it pushes the thoracic vertebra
      to the right side with the internal counterforce created by the heart, which has been shown
      to push the spine to the right with an asymmetric horizontal force in scoliosis patients with
      pectus deformity.

      Based on this, in study, investigators aimed to determine whether there is any relationship
      between pectus deformities and spinal pathologies, and if there is a relationship, with which
      pathology it is most common, whether the type of scoliosis seen in pectus deformities with a
      prominent scoliosis prevalence is a pectus-specific curve, and whether this curve seen in
      scoliosis is associated with pectus. To determine whether there is a footprint or not.
    

Detailed description: 
      The study was planned as a prospective cross-sectional study. Pectus study forms consisting
      of clinical and radiological measurements of the patients aged 3-18 years who applied to the
      outpatient clinic with chest deformity will be filled in in detail, and the Adams test
      (forward bending test) (+) will be measured by Bunnell scoliometer (scoliosis assessment
      tool) and ATR (angle of trunk rotation- trunk rotation) measurements. If ATR measurement is
      above 7 degrees on Bunnell scoliometer, patients who meet the inclusion criteria will be
      included in the study by filling in the informed consent form and a scoliosis radiograph will
      be requested (Independent of investigators' study, it is necessary to withdraw it in line
      with the 2016 recommendations of the International Scientific Society for Scoliosis
      Orthopedic and Rehabilitation Treatment (SOSORT).)

      Coronal, sagittal balance, coronal and sagittal cobb angles will be measured from the
      scoliosis radiograph taken from the Posterior-Anterior (PA) (posterior-anterior) and lateral
      (side) films. Their relationship with chest deformities will be evaluated. All measurements
      will be made and recorded by two independent investigators As a result of the analysis, when
      the power is targeted as 95% and the error amount as 0.05, the minimum sample size required
      for investigators to find a significant difference between the means was determined as 36.
      Investigators formed a sample group of 40 people for our study, together with the fact that
      groups of 36 people were sufficient in terms of providing 95% power. Kappa statistical
      analysis will be used to determine intraobserver and interobserver variations.
    

Intervention name(s): Pectus Study Form; Adams Test; Scoliosis Graphy; Pulmonary function test
Intervention type(s): Diagnostic Test; Diagnostic Test; Diagnostic Test; Diagnostic Test
Intervention description(s): Pectus study forms consisting of clinical and radiological measurements of patients aged 3-18 years who applied to the outpatient clinic with chest deformity will be filled in in detail.
In addition, this study form includes 'Quality of Life Evaluation Form in Pectus Deformity', 'Social Comparison Scale', 'Sleep Disorder Scale for Children', 'Anxiety Disorders Screening Scale in Children', 'Pediatric Quality of Life Questionnaire' designed for patients and their relatives. PedsQL)', 'SRS-22 Patient Questionnaire', 'Beck Anxiety Scale' and 'Informed Consent Form' designed for patients and their relatives.; Adams test (forward bending test) (+) was measured by Bunnell scoliometer (scoliosis assessment tool) and ATR (angle of trunk rotation angle) values were 7 degrees in patients who meet the inclusion criteria will be included in the study by filling out an informed consent form; ATR (angle of trunk rotation) values above 7 degrees on bunnell scoliometer were determined. Afterwards, patients who meet the inclusion criteria will be included in the study by filling out an informed consent form and a scoliosis graphy will be requested.
Coronal, sagittal balance; coronal and sagittal cobb angles will be measured from posterior-anterior (PA) (posterior-anterior) and lateral (lateral) scoliosis radiographs.; Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.
There are 2 types of disorders that cause problems with air moving in and out of the lungs:
Obstructive. This is when air has trouble flowing out of the lungs due to airway resistance. This causes a decreased flow of air.
Restrictive. This is when the lung tissue and/or chest muscles can't expand enough. This creates problems with air flow, mostly due to lower lung volumes.
Other intervention name(s): Forward Bending Test; Orthoroentgenogram; Spirometry Function Test
Observational model: Other
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Pectus study forms consisting of clinical and radiological measurements of patients aged
        3-18 years who applied to the outpatient clinic with chest deformity will be filled in in
        detail. Adams test (forward bending test) (+) was measured by Bunnell scoliometer
        (scoliosis assessment tool) and ATR (angle of trunk rotation angle) values were 5 degrees
        in those with BMI (Body Mass Index) above 85%. If it is below 85% and above 7 degrees,
        patients who meet the inclusion criteria will be included in the study by filling out an
        informed consent form and a scoliosis film will be requested. Scoliosis X-ray
        (orthorontgenogram) will be requested. Coronal, sagittal balance, coronal and sagittal cobb
        angles will be measured. Their relationship with chest deformities will be evaluated. All
        measurements will be made and recorded by two independent researchers.
      
Keywords: Pectus Excavatum; Pectus Carinatum; Scoliosis; Kyphosis; Lordosis