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Dextrocardia and coronal alignment of thoracic curve: a population study
Kaj Tallroth1, Martina Lohman, Markku Heliövaara
1ORTON Research Institute, Invalid Foundation, Helsinki, Finland.
Summary
Individuals with dextrocardia (a heart positioned on the right) frequently exhibit a leftward thoracic spine curve. This spinal alignment may be influenced by the heart
Area of Science:
- Medical imaging
- Anatomy
- Cardiology
Background:
- The thoracic spine typically shows a slight rightward curvature.
- Pulsation forces from the descending aorta may influence spinal alignment.
- Limited research exists on thoracic spine alignment in dextrocardia patients.
Purpose of the Study:
- To evaluate the coronal alignment of the thoracic spine in individuals with dextrocardia.
- To compare thoracic spine radiographs of dextrocardia patients with those of levocardia patients.
Main Methods:
- A nested case-control study design was employed.
- Eight dextrocardia cases were identified from a health survey of 57,440 individuals.
- Four age-, gender-, and municipality-matched levocardia controls were selected for each case.
- Thoracic spine radiographs were analyzed for coronal alignment by blinded observers.
Main Results:
- All eight dextrocardia patients with a right-sided descending aorta displayed a mild left thoracic spine convexity (mean Cobb angle 6.6° left).
- In contrast, 29 of 32 levocardia controls showed right thoracic spine convexity or a straight spine (mean Cobb angle 5.2° right).
- The difference in spinal curvature between the groups was statistically significant (P = 0.00003).
Conclusions:
- A slight left thoracic spine convexity is common in individuals with dextrocardia and a right-sided descending aorta.
- This spinal curvature may result from the pulsatile pressure of the descending thoracic aorta and the cardiac mass effect.
- The findings suggest that the position of the heart and aorta can influence thoracic spine development.
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