Does Pectus Carinatum Cause Scoliosis?

Does your child suffer from pectus carinatum? If so, you may have heard about or read long lists of potential complications or associated conditions that pectus carinatum may cause. One of the most common features associated with pectus carinatum is postural problems, including scoliosis. But what exactly is scoliosis? Is it that serious? And does pectus carinatum actually cause it? These questions — and more — will be answered in the following article. 

What Is Pectus Carinatum?

Pectus carinatum, also known as pigeon chest, is a relatively rare medical condition resulting in the breastbone sticking out abnormally from the chest. It occurs in a relatively small number of people. It is classified as a congenital condition, meaning it is present from birth. However, it does not become obvious in most sufferers until the onset of puberty, when the breastbone structure is growing at the fastest rate. It is four to five times more common in boys than girls[1] and appears to be caused by a combination of genetic and random environmental factors. 

In most patients, pectus carinatum will not cause very serious medical complications. Most often, it may cause issues associated with physical appearance and posture. 

Can Pectus Carinatum Cause Scoliosis?

So does pectus carinatum cause scoliosis? First of all, scoliosis is a condition that causes sideways (left-to-right) curvature of the spine. Although most cases are mild, severe cases can occur in some instances. Like pectus carinatum, it is most commonly diagnosed in adolescents in their early teenage years. However, scoliosis is much more common in the general population than pectus carinatum, as it has a range of potential causes. 

Although there are well-known associations that have been observed between pectus carinatum and scoliosis, the relationship between causation is not as clear. One clinical study found that 21% of patients with either pectus carinatum or pectus excavatum showed signs of scoliosis.[2] The average lateral spinal deformity was 17° (although this ranged from 5° to 57° across all patients studied). Consequently, most patients only showed mild scoliosis, with only 14% of pectus carinatum patients requiring medical intervention. In another study, 23 of 117 patients (20%) with pectus carinatum also had scoliosis.[3]

On the other hand, different studies have shown that some patients with pectus carinatum have a family history of scoliosis.[4] Consequently, it is not currently possible to state definitively whether pectus carinatum causes scoliosis or whether the association is caused by another underlying factor that can increase the risk of both scoliosis and pectus carinatum. However, it can be seen that there is a relatively strong association between these two conditions, meaning that scoliosis is much more likely to occur in children who also have pectus carinatum. 

Does Pectus Carinatum Affect Your Back?

The main feature of pectus carinatum is an overgrowth of the cartilage forming the breastbone, which causes it to protrude from the rest of the chest. This protrusion can affect other regions of the chest and torso. Some patients will experience rib flare, where the bottom part of the rib cage pushes outward. Pectus carinatum can also affect the upper body posture. These can include scoliosis and other conditions, such as kyphosis. This is where the upper back is excessively rounded in a forward direction, causing a hunchback look.

Other symptoms of pectus carinatum can include hooking or rounding of shoulders, as well as overall poor posture. This can lead to upper or lower back pain, as well as increased tension in the back or neck area.

In summary, pectus carinatum does not affect the physical structure of your back, but it can significantly impact posture and spinal alignment. Over time, this can lead to more serious back issues. 

What Other Problems Can Pectus Carinatum Cause?

In addition to the protrusion of the breastbone and abnormal spinal curvature (scoliosis and kyphosis), pectus carinatum may cause a range of other problems, including: 

• Shortness of breath 
• Having hooked or rounded shoulders
• Flaring of the ribs (where they protrude from the rest of the chest)
• Always feeling tired or fatigued
• Increased heart rate (in rare instances)
• Chest pain (in rare instances)

In addition, a number of studies have demonstrated that pectus carinatum is linked to lower self-esteem and less positive body image. 

Help Your Child With a Custom Dakota Brace

Although the exact relationship between pectus carinatum and spinal/back conditions such as scoliosis is not fully understood at present, it is clear that pectus carinatum can cause a range of complications. However, many or all of these potential complications can be resolved or minimized by treatment of the pectus condition. 

It is important to note that pectus carinatum will not improve by itself. On the positive side, effective non-surgical treatment methods are available for this condition. The first method of treatment recommended for nearly all pectus carinatum patients is using an orthotic brace, like the Custom Dakota Brace.[5]

This lightweight brace applies pressure to the protruding region of the breastbone, pushing the cartilage into the desired shape. In younger patients, this will train the cartilage into the correct shape, thus correcting the pectus deformity over time. As the cartilage hardens later during puberty, it sets in the correct shape. Consequently, the brace may need to be worn for around a year or possibly longer. However, bracing treatment is quite effective in most individuals, and recurrence of the condition after a successful bracing program is quite rare. 

Does your child suffer from pectus carinatum? Here at Dakota Brace, we aim to provide the best possible treatment for pectus carinatum at an affordable cost. Arrange a free consultation with one of our health professionals and get $75 off your first order with us!

References

1. Cobben, J. M., Oostra, R. J., & van Dijk, F. S. (2014). Pectus excavatum and carinatum. European Journal of Medical Genetics, 57(8), 414-417.
2. Waters, P., Welch, K., Micheli, L. J., Shamberger, R., & Hall, J. E. (1989). Scoliosis in children with pectus excavatum and pectus carinatum. Journal of Pediatric Orthopaedics, 9(5), 551-556.
3. Heydar, A., & Şirazi, S. (2021, November). Spinal deformities in patients with pectus carinatum. In Orthopaedic Proceedings (Vol. 103, No. S13, pp. 123-123). The British Editorial Society of Bone & Joint Surgery.
4. Shamberger, R. C., & Welch, K. J. (1987). Surgical correction of pectus carinatum. Journal of Pediatric Surgery, 22(1), 48-53.
5. Emil, S. (2018). Current options for the treatment of pectus carinatum: When to brace and when to operate?. European Journal of Pediatric Surgery, 28(04), 347-354.