Factors affecting postoperative pulmonary function deterioration in adolescent idiopathic scoliosis: A prospective study using 3-dimensional image reconstruction by biplanar stereoradiography. (April 2022)

• Record Type: Journal Article
• Authors: Machino, Masaaki; Kawakami, Noriaki; Ohara, Tetsuya; Saito, Toshiki; Tauchi, Ryoji; Imagama, Shiro
• Is Part Of: Journal of clinical neuroscience. Volume 98(2022)
• Page Start: 182
• Page End: 188
• Publication Date: 2022-04
• Subjects: Adolescent idiopathic scoliosis -- Biplanar stereoradiography -- 3D reconstructions -- Rib cage parameter -- Pulmonary function test; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.02.014
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: The biplanar stereoradiography can provide three-dimensional reconstruction images. This study investigated the rib cage parameters and pulmonary function deterioration. A total of 67 adolescent idiopathic scoliosis patients were enrolled in this study. The rib cage parameters reflected postoperative pulmonary function variables. Abstract: This study aimed both to evaluate rib cage parameters in patients with adolescent idiopathic scoliosis (AIS) by three-dimensional (3D) image reconstruction using biplanar stereoradiography (EOS) (EOS Imaging, Paris, France) and identify factors associated with postoperative pulmonary function deterioration (PFD). A total of 67 patients with Lenke type 1 or 2 AIS (59 females and 8 males; mean age, 14.4 years) undergoing posterior corrective fusion with a rod rotation maneuver based on segmental pedicle screw fixation were recruited. 3D images and pulmonary function test results were analyzed preoperatively and at 2 years postoperatively. The following parameters were measured: maximum thickness, maximum width, thoracic index, rib hump, rib cage volume (RCV), spinal penetration index (SPI), endothoracic hump ratio (EHR), vertebra-sternum angle (VSA), rib-vertebra angle difference, vertebral lateral decentering (VLD), forced vital capacity (FVC), and percent predicted FVC (%FVC). PFD was defined as a postoperative %FVC decline of 5% or greater. Patients were divided into two groups, namely PFD and non-PFD. FVC increased from 2.62 L to 2.73 L, while %FVC decreased from 88.7% to 82.7%. The maximum width diminished postoperatively in the PFD group. Patients in the PFD group exhibited a significantly smaller increase in RCV and VLD as well as a significantly smaller decrease in SPI, EHR, and VSA than those in the non-PFD group. The rib cage parameters quantified on 3D images reconstructed using EOS are useful in identifying factors affecting PFD in patients with AIS.