The purpose of this investigation was to characterize severe kyphosis and scoliosis (kyphoscoliosis) and giant hiatal hernia (HH) in a 97-year-old female cadaver. Kyphosis is a ventral curvature of the thoracic spine that exceeds 50°. Scoliosis (lateral spinal curvature) is usually combined with vertebral rotation. HH is a hernia in which part of the gastrointestinal (GI) tract protrudes through the esophageal opening of the diaphragm. Although kyphoscoliosis has been suggested as a causative factor in the development of HH, scarce published data exist. If true, then this is clinically important in the evaluation and treatment of patients that present with spinal deformities and GI symptoms. Gross anatomical dissection was done. Vertebral deformities and displacement of structures were visualized with digital radiologic imaging using full-body x-ray films, and highresolution CT and MRI Scans. Image analysis, multi-planar reformatting, and 3D- reconstruction were done on radiographic series. The Cobb and Aaro-Dahlborn Methods were used to determine the degree of spinal curvature and vertebral rotation, respectively. To examine the possible relationship between kyphoscoliosis and HH, intraabdominal volume (IAV) was measured and compared to the IAV of unaffected cadavers. The heart was displaced superior and to the left with the apex touching the thoracic cage, whereas the aorta was 7.3 cm to the right of midline. The stomach was completely within the mediastinum. Thoracic dextroscoliosis, lumbar levoscoliosis and thoracic kyphosis had Cobb Angles of 45°, 34° and 78°, respectively. All thoracic and lumbar vertebrae were left-rotated; maximum rotations were T12 (18°) and L5 (29°). IAV was 4224 cm3, and that of unaffected females ranged from 4449 to 7927 cm3. This study provides insight into the relationship between kyphoscoliosis and HH. We suggest that reduced IAV caused by kyphoscoliosis may contribute to the development and progression of paraesophageal hernias in patients with laxity of the diaphragmatic hiatal musculature.
|Original language||English (US)|
|Number of pages||12|
|Journal||European Journal of Anatomy|
|State||Published - Jan 1 2015|
- Hiatal hernia
ASJC Scopus subject areas