Postural control impairment in adolescents with developmental anomalies of the anterior chest wall

Background

Modern surgery has made significant progress in the development of minimally invasive approaches for the correction of chest wall deformities. However, the understanding of physiological responses to these surgical interventions remains incomplete. In recent years, growing scientific interest has been directed toward functional diagnostic methods for assessing the musculoskeletal system in patients with this pathology.

Aim

To comparatively analyze changes in vertical balance in adolescents with different types of chest wall deformities during the course of postoperative recovery.

Methods

The study included two groups of adolescents of both sexes aged 13–16 years with severe anterior chest wall deformities. Group 1 comprised 25 adolescents with symmetric pectus excavatum, while group 2 included 12 adolescents with pectus carinatum. All participants underwent comprehensive clinical, radiological, and stabilometric assessments. Minimally invasive reconstructive procedures were performed in all patients to correct the chest wall deformities. Parameters of the body’s center of pressure displacement and pressure centers of the contralateral feet were evaluated preoperatively and two years after surgery, prior to removal of the implanted metal support. Comparative analysis was performed against normative data obtained from a cohort of 20 healthy age-matched children examined by us.

Results

Adolescents with anterior chest wall deformities demonstrated impairments in vertical body balance. In the long-term follow-up period, minimally invasive corrective surgery resulted in opposite changes in postural control mechanisms in the two study groups, as evidenced by a comprehensive analysis of stabilometric parameters. In adolescents with pectus excavatum, the quality of the balance function improved from 76% (56%–82%) to 81% (71%–85%) (p = 0.043). In contrast, adolescents with pectus carinatum exhibited a deterioration in vertical balance, with balance function quality decreasing from 87% (77%–92%) to 79% (68%–87%) (p = 0.034). These changes may be associated with compression of intrathoracic organs following corrective surgery.

Conclusion

The findings provide new opportunities for improving functional monitoring during diagnostic evaluations and surgical treatment, as well as for developing optimized postoperative rehabilitation programs for patients with anterior chest wall deformities.