Spinal Deformities in Pediatric Burn Patients

Introduction Extensive third-degree burns in pediatric patients can be associated with the development of spinal deformities. Methods Forty pediatric burn patients with scoliosis and one with kyphosis were identified based on a retrospective review of patient records at the Shriners Hospital for Children in Galveston, Texas. Results Average age at time of burn was 7 years 4 months. Average age at follow-up was 11 years 10 months. Twenty-one patients had a thoracolumbar curve, with an average of 20 degrees. Sixteen patients had a thoracic curve, with an average of 16 degrees. Three patients had a lumbar curve, with an average of 9 degrees. Five patients had scoliosis greater than 40 degrees. The kyphosis was 90 degrees. All patients had contractile burn scar on the trunk on the concavity of the curve. Discussion Mild scoliosis curves are common following third-degree burns in the pediatric population, but extensive burns at a young age can cause severe curves. Risk factors include burn scar traversing the entire length of the trunk, young age, greater total body surface area burn, and greater percentage of third-degree burn. Soft tissue procedures and bracing may be used to treat flexible curves. Posterior stabilization may be needed for more severe curves.