Assessment of Thoracic Kyphosis Using Flexicurve Ruler after Open Heart Surgery: A Cross-Sectional Study

Abstract

In literature, the development of spinal deformities was reported after surgical intervention for congenital heart disease using thoracotomy and sternotomy incisions in children; however, there are not enough data regarding the incidence of spinal kyphosis after open-heart surgery in adults. This study aimed to determine the impact of open-heart surgery using median sternotomy incision on the sagittal plane thoracic spine curve and pulmonary functions after open-heart surgery. A cross- sectional study was conducted on 100 participants (53 ± 9.43 years), who underwent open heart surgery using median sternotomy. The spinal kyphotic curve was evaluated using a Flexicurve ruler and spirometry parameters [forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and ratio of forced expiratory volume in the first second to forced vital capacity (FEV1/FVC)] were evaluated before and one week after open-heart surgery. The comparison between the preoperative and postoperative measurements of the variables under study was performed using the paired t-test. Statistical significance was set at (P ˂ 0.05). The results revealed a significant increase in the dorsal kyphotic curve (9.75 ± 2.32) and a significant decrease in all spirometry parameters under study [(FVC: 2.12 ± .77); (FEV1:1.55 ± .64) and (FEV1/FVC: 0.72 ± .13)] with an alpha level of (P < 0.05). There is a high incidence of exaggerating the sagittal plane thoracic spine curvature (thoracic kyphosis), and reduction in the pulmonary functions after open-heart surgery using median sternotomy incision.