Affordable Access

deepdyve-link
Publisher Website

Flexibility of the thoracic curve and three-dimensional thoracic kyphosis can predict pulmonary function in nonoperatively treated adult patients with adolescent idiopathic scoliosis.

Authors
  • Ohashi, Masayuki1
  • Watanabe, Kei2
  • Hirano, Toru2
  • Hasegawa, Kazuhiro3
  • Katsumi, Keiichi4
  • Shoji, Hirokazu2
  • Mizouchi, Tatsuki2
  • Endo, Naoto2
  • 1 Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata, 951-8510, Japan. Electronic address: [email protected] , (Japan)
  • 2 Department of Orthopedic Surgery, Niigata University Medical and Dental Hospital, 1-757 Asahimachi Dori, Chuo-ku, Niigata, 951-8510, Japan. , (Japan)
  • 3 Niigata Spine Surgery Center, Japan. , (Japan)
  • 4 Department of Orthopedic Surgery, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan. , (Japan)
Type
Published Article
Journal
Journal of Orthopaedic Science
Publisher
Elsevier
Publication Date
Jul 01, 2020
Volume
25
Issue
4
Pages
551–556
Identifiers
DOI: 10.1016/j.jos.2019.06.015
PMID: 31303435
Source
Medline
Language
English
License
Unknown

Abstract

Although several radiographic predictors for pulmonary function in adolescent patients have been reported, those in adult patients remain unclear. Therefore, we aimed to investigate the associations between spinal deformity and pulmonary function in nonoperatively treated adult patients with adolescent idiopathic scoliosis (AIS). Of 319 patients treated nonoperatively for AIS, 90 (average age, 40.0 ± 6.5 years) underwent both full-length standing radiographs and pulmonary function test. Standard two-dimensional (2-D) radiographic measurements were performed. Three-dimensional thoracic kyphosis (3-D TK) was calculated from 2-D standing radiograph data using a validated formula: 3-D TK (°) = 18.1 + 0.81 × (2-D TK) + 0.54 × (Cobb angle of thoracic curve). 3-D TK was defined as the sum of segmental kyphosis between T5 and T12, which eliminates the overestimation of TK in 2-D measurements due to rotational deformity. Bivariable correlation analysis, followed by a stepwise multiple linear regression analysis, was performed. The average Cobb angle of the thoracic curve at the time of survey was 49.4° ± 14.6° with flexibility of 37.5% ± 18.2%. Thoracic curve magnitude, flexibility, apical vertebral rotation and translation, and 3-D TK were significantly correlated with percent-predicted forced vital capacity (%FVC) and expiratory volume in 1 s (%FEV1.0). Stepwise multiple regression analysis showed that curve flexibility and 3-D TK were significant, independent predictors of %FVC (R2 = 0.358) and %FEV1.0 (R2 = 0.335), curve flexibility having a greater impact (standardized coefficient > 0.45) than 3-D TK (<0.32). Our results indicate that nonoperatively treated patients with AIS should be recommended to maintain flexibility of the thoracic curve to prevent future pulmonary impairment. Moreover, 3-D TK is another independent predictor of pulmonary function, which suggests that segmental sagittal alignment is a component of deformity correction to focus on. Copyright © 2019. Published by Elsevier B.V.

Report this publication

Statistics

Seen <100 times