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Factors of Thoracic Cage Deformity That Affect Pulmonary Function in Adolescent Idiopathic Thoracic Scoliosis

Takahashi, Seiken, MD*; Suzuki, Nobumasa, MD, PhD; Asazuma, Takashi, MD, PhD; Kono, Katsuki, MD*; Ono, Toshiaki, MD, PhD*; Toyama, Yoshiaki, MD, PhD*

doi: 10.1097/01.brs.0000251005.31255.25
Diagnostics
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Study Design. This clinical study examined the association between pulmonary function and thoracic cage deformities in scoliosis.

Objective. To determine the factors in spinal and thoracic cage deformities that affect pulmonary function in scoliosis.

Summary of Background Data. Pulmonary function in scoliosis has generally been evaluated in terms of lateral spinal curvature. No previous report has evaluated changes in pulmonary function taking into consideration measurements reflecting not only spinal curvature but also thoracic cage deformities, although scoliosis is a three-dimensional deformity.

Methods. A total of 109 patients (mean age, 14.2 years) with adolescent idiopathic right thoracic scoliosis (mean lateral spinal curvature, 37.7°) had full assessment of pulmonary function and a radiographic evaluation from radiographs of the whole spine, Moiré topography, and thoracic computed tomography.

Results. Multiple regression analysis (stepwise method) was performed at each vertebral level from T3–T12 to identify the factor that most strongly affects %VC. The correlation coefficient was highest at T9 and next highest at T8, with values of 0.641 (r2 = 0.411, P < 0.0001) and 0.625 (r2 = 0.390, P < 0.0001), respectively. At T9, multiple regression analysis showed that the sagittal diameter of the thoracic cage and the total lung area were identified as factors that most strongly affect %VC. Similarly, the sagittal diameter of the thoracic cage and the rotation angle to the sagittal plane were identified at T8.

Conclusions. The factors that reduced %VC were the sagittal diameter of the thoracic cage, total lung area and vertebral rotation at the T8 and T9 levels.

A total of 109 scoliosis patients had full assessment of pulmonary function and a radiographic evaluation. Multiple regression analysis was performed to the identify factors that most strongly affect %VC. Factors that reduced %VC were the sagittal diameter of the thoracic cage, total lung area, and vertebral rotation at T8 and T9 levels.

From the *Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan; †Saiseikai Central Hospital, Tokyo, Japan; and ‡Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.

Acknowledgment date: November 21, 2005. First revision date: February 16, 2006. Acceptance date: March 14, 2006.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Seiken Takahashi, MD, Department of Orthopaedic Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan; E-mail: seiken45@jcom.home.ne.jp

© 2007 Lippincott Williams & Wilkins, Inc.