Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Pulmonary-Function Tests | Research article

Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis

Authors: Yonggang Wang, Fengguang Yang, Dongmin Wang, Haiyan Zhao, Zhanjun Ma, Peifen Ma, Xuchang Hu, Shixiong Wang, Xuewen Kang, Bingren Gao

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

Login to get access

Abstract

Background

Scoliosis causes thoracic deformities, and it is necessary to assess these changes in pulmonary function test (PFT). To determine how measurements of spinal and thoracic cage deformities are related to pulmonary function.

Methods

Seventy-two patients with main right thoracic curvature in adolescent idiopathic scoliosis (AIS) underwent a PFT and a radiological parameter evaluation of spinal and thoracic cage deformities. Simple and multiple linear regressions were also used to note whether a combination of variables might better predict PFT values. Means were compared using the two-sample t test or one-way ANOVA with Tukey’s multiple comparison methods.

Results

Forced vital capacity (FVC)% predicted had significantly negative correlations with main thoracic curve Cobb (MT-Cobb) (R2 = 0.648, p < 0.001), main thoracic curve-rib hump (MT-RH) (R2 = 0.522, p < 0.001), main thoracic curve apical vertebral body-to-rib ratio (MT-AVB-R) (R2 = 0.536, p < 0.001), and main thoracic curve apical vertebra translation (MT-AVT) (R2 = 0.383, p < 0.001). Multiple regression analysis was performed with FVC% predicted as the dependent variable and MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT as the independent variables. MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT were factors with a significant effect on FVC% predicted (p < 0.001). For 45 patients who had preoperative FVC impairment (FVC% predicted < 80%), their MT-Cobb averaged 76.71°. Twenty-seven patients with normal preoperative FVC (FVC% predicted ≥ 80%) had a smaller mean MT-Cobb of 52.03° (p < 0.001). In other radiological parameters, the impaired FVC group had a MT-AVT of 54.29 mm compared to 38.06 mm for the normal FVC group (p < 0.001). MT-AVB-R averaged 2.92 for the impaired FVC group and 1.78 for the normal FVC group (p < 0.001). MT-RH averaged 28.79 mm for the impaired group and 16.62 mm for the normal group (p < 0.001). Further stratification of preoperative PFT results is divided into three groups. The three groups also showed significant differences in MT-Cobb, MT-RH, MT-AVB-R, and MT-AVT (p < 0.001).

Conclusion

Severe scoliosis leads to an increased degree of thoracic deformity, which increases the risk of lung damage in AIS. Moreover, a more accurate assessment of pulmonary function is achieved through radiological parameters and PFTs.
Literature
1.
go back to reference Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis. BMJ. 2013;346:f2508.CrossRef Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis. BMJ. 2013;346:f2508.CrossRef
2.
go back to reference Perdriolle R, Le Borgne P, Dansereau J, de Guise J, Labelle H. Idiopathic scoliosis in three dimensions: a succession of two-dimensional deformities? Spine (Phila Pa 1976). 2001;26(24):2719–26.CrossRef Perdriolle R, Le Borgne P, Dansereau J, de Guise J, Labelle H. Idiopathic scoliosis in three dimensions: a succession of two-dimensional deformities? Spine (Phila Pa 1976). 2001;26(24):2719–26.CrossRef
3.
go back to reference Stokes IA. Three-dimensional terminology of spinal deformity. A report presented to the Scoliosis Research Society by the Scoliosis Research Society Working Group on 3-D terminology of spinal deformity. Spine (Phila Pa 1976). 1994;19(2):236–48.CrossRef Stokes IA. Three-dimensional terminology of spinal deformity. A report presented to the Scoliosis Research Society by the Scoliosis Research Society Working Group on 3-D terminology of spinal deformity. Spine (Phila Pa 1976). 1994;19(2):236–48.CrossRef
5.
go back to reference Reamy BV, Slakey JB. Adolescent idiopathic scoliosis: review and current concepts. Am Fam Physician. 2001;64(1):111–6.PubMed Reamy BV, Slakey JB. Adolescent idiopathic scoliosis: review and current concepts. Am Fam Physician. 2001;64(1):111–6.PubMed
6.
go back to reference Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.CrossRef Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.CrossRef
7.
go back to reference Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2.CrossRef Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2.CrossRef
8.
go back to reference Agabegi SS, Kazemi N, Sturm PF, Mehlman CT. Natural history of adolescent idiopathic scoliosis in skeletally mature patients: a critical review. J Am Acad Orthop Surg. 2015;23(12):714–23.CrossRef Agabegi SS, Kazemi N, Sturm PF, Mehlman CT. Natural history of adolescent idiopathic scoliosis in skeletally mature patients: a critical review. J Am Acad Orthop Surg. 2015;23(12):714–23.CrossRef
9.
go back to reference Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289(5):559–67.CrossRef Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV. Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. JAMA. 2003;289(5):559–67.CrossRef
10.
go back to reference White H, Wallace J, King J, Augsburger S, Milbrandt T, Iwinski H. A prospective comparison of pulmonary function using traditional and kinematic measures in children with and without adolescent idiopathic scoliosis. Spine Deform. 2015;3(6):554–9.CrossRef White H, Wallace J, King J, Augsburger S, Milbrandt T, Iwinski H. A prospective comparison of pulmonary function using traditional and kinematic measures in children with and without adolescent idiopathic scoliosis. Spine Deform. 2015;3(6):554–9.CrossRef
11.
go back to reference Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis. 2012;7(1):7.CrossRef Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis. 2012;7(1):7.CrossRef
12.
go back to reference Flores F, Cavaleiro J, Lopes AA, Ribeiro F, Oliveira A. Preoperative pulmonary function and respiratory muscle strength in Portuguese adolescents with idiopathic scoliosis. Rev Port Pneumol (2006). 2016;22(1):52–3. Flores F, Cavaleiro J, Lopes AA, Ribeiro F, Oliveira A. Preoperative pulmonary function and respiratory muscle strength in Portuguese adolescents with idiopathic scoliosis. Rev Port Pneumol (2006). 2016;22(1):52–3.
13.
go back to reference Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI. Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Joint J. 2018;100-B(4):415–24.CrossRef Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI. Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Joint J. 2018;100-B(4):415–24.CrossRef
14.
go back to reference Tung R, Uvodich M, Anderson JT, Carpenter K, Sherman A, Lozano R. Do heavier patients with adolescent idiopathic scoliosis have more preserved thoracic kyphosis and pulmonary function? Spine Deform. 2018;6(6):704–6.CrossRef Tung R, Uvodich M, Anderson JT, Carpenter K, Sherman A, Lozano R. Do heavier patients with adolescent idiopathic scoliosis have more preserved thoracic kyphosis and pulmonary function? Spine Deform. 2018;6(6):704–6.CrossRef
15.
go back to reference Saraiva BMA, Araujo GS, Sperandio EF, Gotfryd AO, Dourado VZ, Vidotto MC. Impact of scoliosis severity on functional capacity in patients with adolescent idiopathic scoliosis. Pediatr Exerc Sci. 2018;30:243–50.CrossRef Saraiva BMA, Araujo GS, Sperandio EF, Gotfryd AO, Dourado VZ, Vidotto MC. Impact of scoliosis severity on functional capacity in patients with adolescent idiopathic scoliosis. Pediatr Exerc Sci. 2018;30:243–50.CrossRef
16.
go back to reference Abdelaal AAM, Abd El Kafy EMA, Elayat MSEM, Sabbahi M, Badghish MSS. Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study. J Int Med Res. 2018;46(1):381–91.CrossRef Abdelaal AAM, Abd El Kafy EMA, Elayat MSEM, Sabbahi M, Badghish MSS. Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study. J Int Med Res. 2018;46(1):381–91.CrossRef
17.
go back to reference Newton PO, Faro FD, Gollogly S, Betz RR, Lenke LG, Lowe TG. Results of preoperative pulmonary function testing of adolescents with idiopathic scoliosis. A study of six hundred and thirty-one patients. J Bone Joint Surg Am. 2005;87(9):1937–46.CrossRef Newton PO, Faro FD, Gollogly S, Betz RR, Lenke LG, Lowe TG. Results of preoperative pulmonary function testing of adolescents with idiopathic scoliosis. A study of six hundred and thirty-one patients. J Bone Joint Surg Am. 2005;87(9):1937–46.CrossRef
18.
go back to reference Johnston CE, Richards BS, Sucato DJ, Bridwell KH, Lenke LG, Erickson M, Spinal Deformity Study G: Correlation of preoperative deformity magnitude and pulmonary function tests in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2011, 36(14):1096–1102.CrossRef Johnston CE, Richards BS, Sucato DJ, Bridwell KH, Lenke LG, Erickson M, Spinal Deformity Study G: Correlation of preoperative deformity magnitude and pulmonary function tests in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 2011, 36(14):1096–1102.CrossRef
19.
go back to reference Yu CG, Grant CA, Izatt MT, Labrom RD, Askin GN, Adam CJ, Little JP. Change in lung volume following thoracoscopic anterior spinal fusion surgery: a 3-dimensional computed tomography investigation. Spine (Phila Pa 1976). 2017;42(12):909–16.CrossRef Yu CG, Grant CA, Izatt MT, Labrom RD, Askin GN, Adam CJ, Little JP. Change in lung volume following thoracoscopic anterior spinal fusion surgery: a 3-dimensional computed tomography investigation. Spine (Phila Pa 1976). 2017;42(12):909–16.CrossRef
20.
go back to reference Wen Y, Kai S, Yong-Gang Z, Guo-Quan Z, Tian-Xiang D. Relationship between lung volume and pulmonary function in patients with adolescent idiopathic scoliosis: computed tomographic-based 3-dimensional volumetric reconstruction of lung parenchyma. Clin Spine Surg. 2016;29(8):E396–400.CrossRef Wen Y, Kai S, Yong-Gang Z, Guo-Quan Z, Tian-Xiang D. Relationship between lung volume and pulmonary function in patients with adolescent idiopathic scoliosis: computed tomographic-based 3-dimensional volumetric reconstruction of lung parenchyma. Clin Spine Surg. 2016;29(8):E396–400.CrossRef
21.
go back to reference Winck AD, Heinzmann-Filho JP, Soares RB, da Silva JS, Woszezenki CT, Zanatta LB. Effects of obesity on lung volume and capacity in children and adolescents: a systematic review. Rev Paul Pediatr. 2016;34(4):510–7.PubMedPubMedCentral Winck AD, Heinzmann-Filho JP, Soares RB, da Silva JS, Woszezenki CT, Zanatta LB. Effects of obesity on lung volume and capacity in children and adolescents: a systematic review. Rev Paul Pediatr. 2016;34(4):510–7.PubMedPubMedCentral
22.
go back to reference Jones RL, Nzekwu MMU. The effects of body mass index on lung volumes. Chest. 2006;130(3):827–33.CrossRef Jones RL, Nzekwu MMU. The effects of body mass index on lung volumes. Chest. 2006;130(3):827–33.CrossRef
23.
go back to reference Winter RB, Lonstein JE, Denis F. Sagittal spinal alignment: the true measurement, norms, and description of correction for thoracic kyphosis. J Spinal Disord Tech. 2009;22(5):311–4.CrossRef Winter RB, Lonstein JE, Denis F. Sagittal spinal alignment: the true measurement, norms, and description of correction for thoracic kyphosis. J Spinal Disord Tech. 2009;22(5):311–4.CrossRef
24.
go back to reference Malfair D, Flemming AK, Dvorak MF, Munk PL, Vertinsky AT, Heran MK, Graeb DA. Radiographic evaluation of scoliosis: review. AJR Am J Roentgenol. 2010;194(3 Suppl):S8–22.CrossRef Malfair D, Flemming AK, Dvorak MF, Munk PL, Vertinsky AT, Heran MK, Graeb DA. Radiographic evaluation of scoliosis: review. AJR Am J Roentgenol. 2010;194(3 Suppl):S8–22.CrossRef
25.
go back to reference Zhang H, Sucato DJ, Richards BS. Principles of Surgical Plan for Adolescent Idiopathic Scoliosis. 1st ed. Beijing China: People’s Health Publishing House; 2015. Zhang H, Sucato DJ, Richards BS. Principles of Surgical Plan for Adolescent Idiopathic Scoliosis. 1st ed. Beijing China: People’s Health Publishing House; 2015.
26.
go back to reference Kuklo TR, Potter BK, Lenke LG. Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech. 2005;18(2):139–47.CrossRef Kuklo TR, Potter BK, Lenke LG. Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech. 2005;18(2):139–47.CrossRef
27.
go back to reference Kuklo TR, Potter BK, Polly DW Jr, O'Brien MF, Schroeder TM, Lenke LG. Reliability analysis for manual adolescent idiopathic scoliosis measurements. Spine (Phila Pa 1976). 2005;30(4):444–54.CrossRef Kuklo TR, Potter BK, Polly DW Jr, O'Brien MF, Schroeder TM, Lenke LG. Reliability analysis for manual adolescent idiopathic scoliosis measurements. Spine (Phila Pa 1976). 2005;30(4):444–54.CrossRef
28.
go back to reference Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.CrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.CrossRef
29.
go back to reference Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68.CrossRef Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, Coates A, van der Grinten CP, Gustafsson P, Hankinson J, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005;26(5):948–68.CrossRef
30.
go back to reference Yaszay B, Bastrom TP, Bartley CE, Parent S, Newton PO. The effects of the three-dimensional deformity of adolescent idiopathic scoliosis on pulmonary function. Eur Spine J. 2017;26(6):1658–64.CrossRef Yaszay B, Bastrom TP, Bartley CE, Parent S, Newton PO. The effects of the three-dimensional deformity of adolescent idiopathic scoliosis on pulmonary function. Eur Spine J. 2017;26(6):1658–64.CrossRef
31.
go back to reference Dreimann M, Hoffmann M, Kossow K, Hitzl W, Meier O, Koller H. Scoliosis and chest cage deformity measures predicting impairments in pulmonary function: a cross-sectional study of 492 patients with scoliosis to improve the early identification of patients at risk. Spine (Phila Pa 1976). 2014;39(24):2024–33.CrossRef Dreimann M, Hoffmann M, Kossow K, Hitzl W, Meier O, Koller H. Scoliosis and chest cage deformity measures predicting impairments in pulmonary function: a cross-sectional study of 492 patients with scoliosis to improve the early identification of patients at risk. Spine (Phila Pa 1976). 2014;39(24):2024–33.CrossRef
32.
go back to reference Yaszay B, Jankowski PP, Bastrom TP, Lonner B, Betz R, Shah S, Asghar J, Miyanji F, Samdani A, Newton PO. Progressive decline in pulmonary function 5 years post-operatively in patients who underwent anterior instrumentation for surgical correction of adolescent idiopathic scoliosis. Eur Spine J. 2019;28(6):1322–30.CrossRef Yaszay B, Jankowski PP, Bastrom TP, Lonner B, Betz R, Shah S, Asghar J, Miyanji F, Samdani A, Newton PO. Progressive decline in pulmonary function 5 years post-operatively in patients who underwent anterior instrumentation for surgical correction of adolescent idiopathic scoliosis. Eur Spine J. 2019;28(6):1322–30.CrossRef
33.
go back to reference Lopes AA, Flores F, Ribeiro F, Oliveira A. Pulmonary function and respiratory muscle strength after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis. Pulmonology. 2018;24(3):194–5.CrossRef Lopes AA, Flores F, Ribeiro F, Oliveira A. Pulmonary function and respiratory muscle strength after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis. Pulmonology. 2018;24(3):194–5.CrossRef
34.
go back to reference Lao L, Weng X, Qiu G, Shen J. The role of preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis. J Orthop Surg Res. 2013;8:32.CrossRef Lao L, Weng X, Qiu G, Shen J. The role of preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis. J Orthop Surg Res. 2013;8:32.CrossRef
35.
go back to reference Upadhyay SS, Mullaji AB, Luk KD, Leong JC. Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 1995;20(22):2415–20.CrossRef Upadhyay SS, Mullaji AB, Luk KD, Leong JC. Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 1995;20(22):2415–20.CrossRef
36.
go back to reference Huh S, Eun LY, Kim NK, Jung JW, Choi JY, Kim HS. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children. Korean J Pediatr. 2015;58(6):218–23.CrossRef Huh S, Eun LY, Kim NK, Jung JW, Choi JY, Kim HS. Cardiopulmonary function and scoliosis severity in idiopathic scoliosis children. Korean J Pediatr. 2015;58(6):218–23.CrossRef
37.
go back to reference Johari J, Sharifudin MA, Ab Rahman A, Omar AS, Abdullah AT, Nor S, Lam WC, Yusof MI. Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients. Singap Med J. 2016;57(1):33–8.CrossRef Johari J, Sharifudin MA, Ab Rahman A, Omar AS, Abdullah AT, Nor S, Lam WC, Yusof MI. Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients. Singap Med J. 2016;57(1):33–8.CrossRef
Metadata
Title
Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis
Authors
Yonggang Wang
Fengguang Yang
Dongmin Wang
Haiyan Zhao
Zhanjun Ma
Peifen Ma
Xuchang Hu
Shixiong Wang
Xuewen Kang
Bingren Gao
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1451-z

Other articles of this Issue 1/2019

Journal of Orthopaedic Surgery and Research 1/2019 Go to the issue