Does the funnel deformity affects the sagittal balance of the spine? This question is a result of a Principal Investigator's novel observation, that in some cases restoring the correct balance reduce the distance between the retracted sternum and the spine.

The aim of the study was to assess that sagittal balance of the spine change 6 months after surgical treatment?

We assess:

1. Deviations in sagittal balance in patients before the procedure by X-ray.
2. Change in the distance between the sternum and the anterior part of the nearest vertebral body after virtual reproduction of the correct sagittal balance by AI.
3. Change in the distance between the sternum and the anterior part of the nearest vertebral body 6 months after the Nuss procedure by X-ray.

Assessment of sagittal spine balance in patients operated on for anterior chest wall funnel deformity.

Inclusion criteria:

age 10-18 idiopathic funnel chest Haller index above 3.2

Exclusion criteria:

Previous surgery within the chest and spine regions Anterior chest wall deformities caused by other disease syndromes (e.g. Marfan syndrome, Ehlers-Danlos syndrome) Haller index below 3.2

Study protocol:

1. Computed tomography of the chest.
2. Before the procedure, x-ray of the entire spine in a standing position, including the entire chest, pelvis and hip joints in the anterior and lateral projections (technical parameters will be provided separately).
3. Six months after the procedure, x-ray of the entire spine in a standing position, including the entire chest, pelvis and hip joints in the anterior and lateral projections (technical parameters will be provided separately).

The following are measured:

1. Haller index
2. Asymmetry index
3. Assessment of the Cobb angle in the case of disorders in the frontal plane - before and 6 months after the procedure
4. Assessment of the sagittal balance of the spine (details in a separate document) - before and 6 months after the procedure

We assess:

1. Deviations in sagittal balance in patients before the procedure by X-ray.
2. Change in the distance between the sternum and the anterior part of the nearest vertebral body after virtual reproduction of the correct sagittal balance by AI.
3. Change in the distance between the sternum and the anterior part of the nearest vertebral body 6 months after the Nuss procedure by X-ray.

Objective:

1. Does the funnel deformity affects the sagittal balance of the spine?
2. Does restoring the correct balance reduce the distance between the retracted sternum and the spine (AI)?
3. Does the sagittal balance of the spine change 6 months after surgical treatment?

Inclusion Criteria:

• idiopathic funnel chest
• Haller index above 3.2

Exclusion Criteria:

• Previous surgery within the chest and spine regions
• Anterior chest wall deformities caused by other disease syndromes (e.g. Marfan syndrome, Ehlers-Danlos syndrome)
• Haller index below 3.2

Pediatric patients operated on for anterior chest wall deformity.

After asking of principal investigator