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This study assessed musculoskeletal and pulmonary outcomes in adults who underwent neonatal thoracotomy for EA using real-time magnetic resonance imaging (rt-MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 09\/2022 and 02\/2023, 30 adult EA patients and 22 healthy controls underwent rt-MRI to evaluate chest wall motion, lung volumes, and anatomical deformities. Thoracic cross-sectional area (CSA), lung volumes, and rib\/spinal abnormalities were analyzed using a 3 Tesla MRI system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Rib adhesions and fusions were significantly more frequent in EA patients (90%) than in controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Scoliosis was present in 43% of patients, with many cases moderate to severe (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). EA patients showed reduced thoracic CSA and lung volumes on the operated side (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and significantly impaired chest wall motility (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Scoliosis prevalence was higher in adults (43%) than in children (14%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the significant long-term musculoskeletal and pulmonary sequelae in adults following open EA repair, with the pioneering application of rt-MRI. These findings emphasize the risks associated with open surgery for EA, underscoring the need for long-term, multidisciplinary follow-up and preventive strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This is the first study to use real-time MRI to assess dynamic thoracic function in adults after open repair of esophageal atresia (EA), revealing significant long-term musculoskeletal and pulmonary impairments.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Findings include high rates of scoliosis, rib anomalies, and reduced chest wall motility and lung volume on the operated side.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Results underscore the need for long-term, multidisciplinary follow-up and inform future strategies to reduce morbidity after neonatal thoracotomy.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41390-025-04568-y","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T15:41:23Z","timestamp":1764776483000},"page":"230-235","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adults following open esophageal atresia repair: evaluating long-term musculoskeletal and pulmonary outcomes using insights from real-time MRI"],"prefix":"10.1038","volume":"100","author":[{"given":"Ophelia","family":"Aubert","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Lacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Frahm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Voit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Widenmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz Wolfgang","family":"Hirsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Rosolowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gr\u00e4fe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"4568_CR1","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1053\/j.sempedsurg.2008.10.010","volume":"18","author":"RJ Rintala","year":"2009","unstructured":"Rintala, R. 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