Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Can Breast Asymmetry Following the Treatment of Juvenile Idiopathic Scoliosis with Growing Rod Be Prevented? : A Preliminary Analysis

  • Atici, Yunus (Department of Orthopedics and Traumatology, Medical Park Gebze Hospital) ;
  • Polat, Baris (Department of Orthopedics and Traumatology, University of Kyrenia) ;
  • Erdogan, Sinan (Department of Orthopedics and Traumatology, Baltalimani Bone and Joint Diseases Training and Research Hospital) ;
  • Gurpinar, Tahsin (Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital) ;
  • Demiroz, Serdar (Department of Orthopedics and Traumatology, Medical Park Gebze Hospital)
  • Received : 2019.09.19
  • Accepted : 2019.11.09
  • Published : 2020.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : It can be assumed that the progression of scoliosis in the juvenile period will increase the asymmetry in the rib cage, and thus will contribute to an increase in the breast asymmetry (BA) in the future. We are looking for answers to the questions; "How will the breasts look with respect to each other and what is the possibility of developing BA in the early follow-up period following the early surgical treatment and final fusion surgery of juvenile idiopathic scoliosis (JIS)?" For this reason, in this study, we aimed to evaluate the breast asymmetries of patients in the period after the final fusion. Methods : Following growing rod treatment, final fusion was achieved in 12 females with JIS. We used the anthropomorphic measurement of the modified BREAST-V formula to assess whether there was an asymmetry between the breasts after an average of 4.8 years (2-11) following final fusion. Results : In comparison, the mean volume of the left breast (222.4 mL [range, 104.1-330.2]) was larger than the mean volume of the right breast volume (214.5 mL [range, 95.2-326.7]) (p=0.034). The left breast was larger in 75% of the patients. BA was observed in 50% of the patients. No correlation was detected between the Cobb angle of the patient after final fusion and BA (p=0.688). Conclusion : In the late follow-up period, BA was detected in 50% of the patients with JIS who achieved final fusion after treatment with growing rod. In majority of the patients, left breast was larger. The patients with JIS and their families can be informed prior to the operation about the probability of BA seen in the follow-up period after fusion.

Keywords

References

  1. Akbarnia BA, Marks DS, Boachie-Adjei O, Thompson AG, Asher MA : Dual growing rod technique for the treatment of progressive early-onset scoliosis: a multicenter study. Spine (Phila Pa 1976) 30(17 Suppl) : S46-S57, 2005 https://doi.org/10.1097/01.brs.0000175190.08134.73
  2. Atici Y, Akman YE, Erdogan S, Sari S, Yavuz U, Carkci E, et al. : The effect of growing rod lengthening technique on the sagittal spinal and the spinopelvic parameters. Eur Spine J 24 : 1148-1157, 2015 https://doi.org/10.1007/s00586-014-3422-8
  3. Bekmez S, Demirkiran HG, Dede O, Atici Y, Balioglu MB, Kruyt M, et al. : Spinal instrumentation in growing children retards the natural development of pelvic incidence. J Pediatr Orthop 39 : 141-145, 2019 https://doi.org/10.1097/BPO.0000000000000882
  4. Bulstrode N, Bellamy E, Shrotria S : Breast volume assessment: comparing five different techniques. Breast 10 : 117-123, 2001 https://doi.org/10.1054/brst.2000.0196
  5. Caniklioglu M, Gokce A, Ozturkmen Y, Gokay NS, Atici Y, Uzumcugil O : Clinical and radiological outcome of the growing rod technique in the management of scoliosis in young children. Acta Orthop Traumatol Turc 46 : 379-384, 2012
  6. Chen SH, Huang TJ, Lee YY, Hsu RW : Pulmonary function after thoracoplasty in adolescent idiopathic scoliosis. Clin Orthop Relat Res 399 : 152-161, 2002 https://doi.org/10.1097/00003086-200206000-00018
  7. Cholewicki J, Crisco JJ 3rd, Oxland TR, Yamamoto I, Panjabi MM : Effects of posture and structure on three-dimensional coupled rotations in the lumbar spine. A biomechanical analysis. Spine (Phila Pa 1976) 21 : 2421-2428, 1996 https://doi.org/10.1097/00007632-199611010-00003
  8. Cruz NI, Korchin L : Breast asymmetry pattern in women with idiopathic scoliosis. Bol Asoc Med P R 105 : 9-12, 2013
  9. Denoel C, Aguirre MF, Bianco G, Mahaudens PH, Vanwijck R, Garson S, et al. : Idiopathic scoliosis and breast asymmetry. J Plast Reconstruct Aesthet Surg 62 : 1303-1308, 2009 https://doi.org/10.1016/j.bjps.2008.04.031
  10. Duri R, Brown K, Johnson M, McIntosh A : Patients' perceptions of breast asymmetry improve after spinal fusion for adolescent idiopathic scoliosis. Spine Deform 7 : 80-83, 2019 https://doi.org/10.1016/j.jspd.2018.06.011
  11. Eidlitz-Markus T, Mukamel M, Haimi-Cohen Y, Amir J, Zeharia A : Breast asymmetry during adolescence: physiologic and non-physiologic causes. Isr Med Assoc J 12 : 203-206, 2010
  12. Gabriel A, Fritzsche S, Creasman C, Baqai W, Mordaunt D, Maxwell GP : Incidence of breast and chest wall asymmetries: 4D photography. Aesthet Surg J 31 : 506-510, 2011 https://doi.org/10.1177/1090820X11410868
  13. Harvey CJ Jr, Betz RR, Clements DH, Huss GK, Clancy M : Are there indications for partial rib resection in patients with adolescent idiopathic scoliosis treated with Cotrel-Dubousset instrumentation? Spine (Phila Pa 1976) 18 : 1593-1598, 1993 https://doi.org/10.1097/00007632-199309000-00005
  14. Hayashi K, Upasani VV, Pawelek JB, Aubin CE, Labelle H, Lenke LG, et al. : Three-dimensional analysis of thoracic apical sagittal alignment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 34 : 792-797, 2009 https://doi.org/10.1097/BRS.0b013e31818e2c36
  15. Hong JY, Suh SW, Easwar TR, Modi HN, Yang JH, Park JH : Evaluation of the three-dimensional deformities in scoliosis surgery with computed tomography: efficacy and relationship with clinical outcomes. Spine (Phila Pa 1976) 36 : E1259-E1265, 2011 https://doi.org/10.1097/brs.0b013e318205e413
  16. Huang NS, Quan CL, Mo M, Chen JJ, Yang BL, Huang XY, et al. : A prospective study of breast anthropomorphic measurements, volume and ptosis in 605 Asian patients with breast cancer or benign breast disease. PLoS One 12 : e0172122, 2017 https://doi.org/10.1371/journal.pone.0172122
  17. Illes T, Tunyogi-Csapo M, Somoskeoy S : Breakthrough in three-dimensional scoliosis diagnosis: significance of horizontal plane view and vertebra vectors. Eur Spine J 20 : 135-143, 2011 https://doi.org/10.1007/s00586-010-1566-8
  18. Jefferson RJ, Weisz I, Turner-Smith AR, Harris JD, Houghton GR : Scoliosis surgery and its effect on back shape. J Bone Joint Surg Br 70 : 261-266, 1988
  19. Kovacs L, Eder M, Hollweck R, Zimmermann A, Settles M, Schneider A, et al. : Comparison between breast volume measurement using 3D surface imaging and classical techniques. Breast 16 : 137-145, 2007 https://doi.org/10.1016/j.breast.2006.08.001
  20. Longo B, Farcomeni A, Ferri G, Campanale A, Sorotos M, Santanelli F : The BREAST-V: a unifying predictive formula for volume assessment in small, medium and large breasts. Plast Reconstr Surg 132 : 1e-7e, 2013 https://doi.org/10.1097/PRS.0b013e318290f6bd
  21. Mao SH, Qiu Y, Zhu ZZ, Zhu F, Liu Z, Wang B : Clinical evaluation of the anterior chest wall deformity in thoracic adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 37 : E540-E548, 2012 https://doi.org/10.1097/BRS.0b013e31823a05e6
  22. Mao SH, Shi B, Sun X, Liu Z, Zhu ZZ, Qian BP, et al. : Morphometric analysis of iatrogenic breast asymmetry secondary to operative breast shape changes in thoracic adolescent idiopathic scoliosis. Eur Spine J 25 : 3075-3081, 2016 https://doi.org/10.1007/s00586-016-4554-9
  23. Min K, Waelchli B, Hahn F : Primary thoracoplasty and pedicle screw instrumentation in thoracic idiopathic scoliosis. Eur Spine J 14 : 777-782, 2005 https://doi.org/10.1007/s00586-005-0977-4
  24. Normelli H, Sevastik JA, Ljung G, Jonsson-Soderstrom AM : The symmetry of the breasts in normal and scoliotic girls. Spine (Phila Pa 1976) 11 : 749-752, 1986 https://doi.org/10.1097/00007632-198609000-00016
  25. Oh CH, Shim YS, Yoon SH, Park HC, Park CO, Lee MS : The psychopathological influence of adolescent idiopathic scoliosis in korean male : an analysis of multiphasic personal inventory test results. J Korean Neurosurg Soc 53 : 13-18, 2013 https://doi.org/10.3340/jkns.2013.53.1.13
  26. Perdriolle R, Vidal J : Morphology of scoliosis: three-dimensional evolution. Orthopedics 10 : 909-915, 1987 https://doi.org/10.3928/0147-7447-19870601-10
  27. Poncet P, Dansereau J, Labelle H : Geometric torsion in idiopathic scoliosis: three-dimensional analysis and proposal for a new classification. Spine (Phila Pa 1976) 26 : 2235-2243, 2001 https://doi.org/10.1097/00007632-200110150-00015
  28. Ramsay J, Joncas J, Gilbert G, Trop I, Cheriet F, Labelle H, et al. : Is breast asymmetry present in girls with adolescent idiopathic scoliosis? Spine Deform 2 : 374-379, 2014 https://doi.org/10.1016/j.jspd.2014.05.002
  29. Ramsay J, Seoud L, Barchi S, Cheriet F, Joncas J, Turgeon I, et al. : Assessment of breast asymmetry in adolescent idiopathic scoliosis using an automated 3D body surface measurement technique. Spine Deform 5 : 152-158, 2017 https://doi.org/10.1016/j.jspd.2017.01.001
  30. Rohrich RJ, Hartley W, Brown S : Incidence of breast and chest wall asymmetry in breast augmentation: a retrospective analysis of 100 patients. Plast Reconstr Surg 111 : 1513-1519; discussion 1520-1523, 2003 https://doi.org/10.1097/01.PRS.0000049636.17522.1B
  31. Shi B, Mao S, Sun X, Xu L, Zhu Z, et al. : Both bilateral breast volume discrepancy and asymmetric anterior chest wall shape contribute to the unsightly breast contour in female right thoracic idiopathic scoliosis. Clin Spine Surg 30 : E344-E350, 2017 https://doi.org/10.1097/BSD.0000000000000128
  32. Sigurdson LJ, Kirkland SA : Breast volume determination in breast hypertrophy: an accurate method using two anthropomorphic measurements. Plast Reconstr Surg 118 : 313-320, 2006 https://doi.org/10.1097/01.prs.0000227627.75771.5c
  33. Thompson GH, Akbarnia BA, Kostial P, Poe-Kochert C, Armstrong DG, Roh J, et al. : Comparison of single and dual growing rod techniques followed through definitive surgery: a preliminary study. Spine (Phila Pa 1976) 30 : 2039-2044, 2005 https://doi.org/10.1097/01.brs.0000179082.92712.89
  34. Tsai FC, Hsieh MS, Liao CK, Wu ST : Correlation between scoliosis and breast asymmetries in women undergoing augmentation mammaplasty. Aesth Plast 34 : 374-380, 2010 https://doi.org/10.1007/s00266-010-9506-x
  35. Uzumcugil O, Atici Y, Ozturkmen Y, Yalcinkaya M, Caniklioglu M : Evaluation of shoulder balance through growing rod intervention for earlyonset scoliosis. J Spinal Disord Tech 25 : 391-400, 2012 https://doi.org/10.1097/BSD.0b013e318227b52d