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Thread: Pectus Excavatum

  1. #1
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    Pectus Excavatum

    My 11 year old daughter has scoliosis. Sometime in the last few months I have noticed that she has a dent in the centre if her rib cage. This dent is very small but big enough for me to have noticed. Tonight she pointed it out to me for the first time. I have had a quick search on the internet and have come up with "Pectus Excavatum", which seems to be connected somehow/sometimes with scoliosis.

    My question is - does anyone know anything about this? If she has it, is it likely to 'progress' with her scoli? Am I just becoming paranoid???

    Thank you in advance,

    Laura
    UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
    10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
    Surgery due to take place early December 2011 at the RNOH, England.

  2. #2
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    Quote Originally Posted by RugbyLaura View Post
    My 11 year old daughter has scoliosis. Sometime in the last few months I have noticed that she has a dent in the centre if her rib cage. This dent is very small but big enough for me to have noticed. Tonight she pointed it out to me for the first time. I have had a quick search on the internet and have come up with "Pectus Excavatum", which seems to be connected somehow/sometimes with scoliosis.

    My question is - does anyone know anything about this? If she has it, is it likely to 'progress' with her scoli? Am I just becoming paranoid???

    Thank you in advance,

    Laura
    Hey Laura,

    My answer is necessarily incomplete.

    Both my daughters had a moderate case of pectus excavatum as toddlers which resolved on its own. It was very noticeable at the time but they do not have any indentation now.

    Pectus excavatum is one of several possible indicators of certain conditions including Marfan's syndrome which is also associated with scoliosis. That is the only connection between pectus excavatum and scoliosis that I know about. The fact that my girls had pectus excavatum along with several other indicators is why I had them evaluated by a geneticist and pediatric cardiologist for Marfan's syndrome.

    Pectus excavatum does not in and of itself signal anything as far as I know. It is when it occurs with the constellation of other indicators that it can mean something though not necessarily even in that case.

    If it doesn't resolve and does not present problems, it tends to increase the cleavage aspect in women which is a positive thing for some.

    That's the extent of what I know about it.

    sharon
    Last edited by Pooka1; 10-23-2008 at 09:01 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  3. #3
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    Thanks for that Sharon. I'm sure it's nothing, just something that she and I had noticed at the same time which made me wonder. Immy actually talked about a boy at her old school who had quite a big dip in his chest. Apparently he had told everyone that he was the only person with one and that was what made him so good at sport! She found it most amusing whet she spotted her own (albeit small) dent. If it's not going to grow then I'm not going to worry and...

    Quote Originally Posted by Pooka1 View Post
    If it doesn't resolve and does not present problems, it tends to increase the cleavage aspect in women which is a positive thing for some.
    I could even become quite envious. Better not tell her dad though as he'll never let her out of the house without a high cut top!

    Thanks

    Laura
    UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
    10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
    Surgery due to take place early December 2011 at the RNOH, England.

  4. #4
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    Hi Laura, you seem to emphasize the idea that the indentation is very small. Could it be that you two are actually looking just below the end of the zyphoid process (sternum)? If this were related to Marfan's syndrome, one of the other key elements to it is disproportionately long limbs. Don't confuse that with the longer limbs of the pubertal growth spurt. So as not to take the chance of misinforming you, or scare you, the best thing to do is do a Google search on the subject. If it get's worse, there is a fairly simple procedure to correct it. It does involve surgery, but as surgery goes, it's relatively minor. Another search on that will supply more info that you'll ever want.

  5. #5
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    My 20 year old son had a severe case of PE and slight scoliosis. He had surgery for the PE but fortunately his curve stabilized at about 11 degrees.Some cases of PE never get worse during adolescent growth some do. Look for that visual change also any problems with breathing, endurance or pain during exercise. In that case ,tests will be performed to see if indeed the PE is the problem and if surgery is indicated.Marfans is often associated with PE but again not always. Talk to your physician about your concerns. If he tells you PE is only cosmetic and does not cause health problems find another doctor. My 15 yo daughter just finished bracing for scoliosis and she has no signs of PE. Its much easier to hide in girls but the mental anguish associated with an "abnormal looking"chest can be devastating for boys and some girls.

  6. #6
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    Thank you Slice & leokatmom. I think it probably is nothing - may be something to do with being muscular & having very little body fat? I say this because I've noticed my hubby seems to have one (dent) too.

    Panic over.

    Thanks

    Laura
    UK based Mum of Imogen, 38 degree curve at 9 years old. SpineCor since 15/6/07, 31 degrees in brace.
    10th December 07 - 27 degrees, 23rd June 08 - 26 degrees, Feb 09 - 24 degrees, Aug 09 - 35 degrees, Jul 10 - 47 degrees, Dec 10 - 50+ degrees.
    Surgery due to take place early December 2011 at the RNOH, England.

  7. #7
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    I'm 13 now, but when I was 11 I noticed that about myself, too. I told my mom, we went to the doctor, and I not only had scoliosis but a pectus deformity. It sounds like the excavatum thing to me, it might be similar or the same thing, I'm not sure. The doctor said that the brace I'm getting (friday) will help my scoliosis, not the pectus deformity though. I also have always had trouble breathing, and the doctors think it might have something to do with my lungs not having enough room because of the pectus deformity.
    I don't think of my back brace as a disadvantage.

    I think of it as something that will help me, and I am fortunate to have the oppurtunity to fix my scoliosis.

  8. #8
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    Quote Originally Posted by leokatmom View Post
    My 20 year old son had a severe case of PE and slight scoliosis. He had surgery for the PE but fortunately his curve stabilized at about 11 degrees.
    This has been talked about in different groups for a while now, what do you think? PE gets corrected by surgery, scoliosis becomes a non-issue. No surgery for the PE, scoliosis takes off . . .?? Seen it in a few people now. Coincidence?


    p

  9. #9
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    Quote Originally Posted by pat View Post
    This has been talked about in different groups for a while now, what do you think? PE gets corrected by surgery, scoliosis becomes a non-issue. No surgery for the PE, scoliosis takes off . . .?? Seen it in a few people now. Coincidence?


    p
    What about where a moderate case of PE corrects itself completely in two girls and the scoliosis takes off at two different rates in each girl?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  10. #10
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    We were just at our yearly appointment for my daughters pectus. Her goes along with the scoliosis the ped surgeon said.
    The worse the scoli gets,the worse her pectus gets,but right now no surgery is needed.

    Jennie

  11. #11
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    Quote Originally Posted by Pooka1 View Post
    What about where a moderate case of PE corrects itself completely in two girls and the scoliosis takes off at two different rates in each girl?
    So, which girl's pectus corrected, the one whose scoliosis slowed down? p

  12. #12
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    Quote Originally Posted by borngmama View Post
    The worse the scoli gets,the worse her pectus gets,but right now no surgery is needed.

    Jennie
    So, do you correct the pectus, and the scoli slows down? Sounds like that's what he could be saying.??? Interesting? p

  13. #13
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    Quote Originally Posted by pat View Post
    So, which girl's pectus corrected, the one whose scoliosis slowed down? p
    They are identical twins. They each had a moderate case of PE as toddlers which corrected itself completely before they reached school age. No surgery. They have no indication of ever having had PE at this point.

    Both have AIS. One's curve moved very quickly and she was fused. The other is in a brace which is failing to hold the curve and will likely be fused at some point.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  14. #14
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    Quote Originally Posted by pat View Post
    This has been talked about in different groups for a while now, what do you think? PE gets corrected by surgery, scoliosis becomes a non-issue. No surgery for the PE, scoliosis takes off . . .?? Seen it in a few people now. Coincidence?


    p
    How does surgical correction of PE affect the amount or rate of spine curvature with scoliosis? What's the working hypothesis?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  15. #15
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    New Procedure for PE developed at UCSF

    This new treatment for PE was posted on another scoliosis forum.
    Fascinating procedure. Maybe they'll be able to adapt it for scoliosis someday

    Magnetic Mini-Mover Procedure
    For more than 50 years, pectus excavatum has been corrected by major surgical reconstruction through the use of either the Nuss or Ravitch procedures. Both of these procedures require big operations and hospitalization for pain management.

    In an effort to make the pectus excavatum operation better for patients and their families, we have developed a novel method to correct the Pectus Excavatum chest wall deformity. With the Magnetic Mini-Mover Procedure (3MP), the deformed costal cartilage is gradually reformed by a controlled gradual outward "pull" on the depressed breastbone. This is achieved with only minimal surgery and without the need for painful implanted chest wall struts.

    http://pedsurg.ucsf.edu/conditions--...procedure.aspx
    Mom to Haley, 13.5 yrs old
    Diagnosed at 6 yrs old - 18T.
    Boston Brace at 9.5 yrs old - 34T/18L
    Switched to SpineCor at 10 yrs old
    Stable at ~22T OBX until 12.5 yrs old
    Adolescent growth spurt was brutal - scheduled for surgery Dec 7th.

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