Surgical and Radiologic Anatomy

, Volume 41, Issue 3, pp 287–296 | Cite as

Thoracic cage volume and dimension assessment by optoelectronic molding in normal children and adolescents during growth

  • Federico CanaveseEmail author
  • Alain Dimeglio
  • François Bonnel
  • Marco Corradin
  • Bruno Pereira
  • Amélie Marcoul
  • Yann Philippe Charles
Original Article



The thoracic spine, the chondral and osseous ribs, and the sternum together make up the thoracic cage. These elements are strictly correlated, although their growth is not synchronous. The purpose of this study is to provide a comprehensive data set of thoracic dimensions and non-invasive volumetric assessment in a large cohort of males and females from early childhood to young adult age.


In all, 622 healthy individuals (406 girls, 216 boys) aged 6–18 years were consecutively enrolled between 2006 and 2016. All had to be healthy with no history of spinal deformity, or any lung, cardiovascular, systemic or neuromuscular disease. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic cage volume (V) and perimeter (Pe), anterior–posterior depth (AP) and transverse diameter (TD), AP/TD ratio, sternal length (St), and T1–T12 distance (Tle) in all patients.


The overall average age was 11.1 ± 2.5 years (4–18) for girls and 11.0 ± 3.1 years (4–18) for boys. Average growth parameters were: standing height 146.2 ± 14.6 cm (103–172) for girls and 146.4 ± 20.0 cm (94–192) for boys, sitting height 75.4 ± 8.6 cm (61–91) for girls and 75.5 ± 10.3 cm (60–99) for boys, weight 37.6 ± 10.4 kg (16–65) for girls and 38.3 ± 14.3 kg (13.7–104) for boys, BMI 16.7 ± 3.7 (18.5–26) for girls and 17.0 ± 3.3 (18.7–34.3) for boys. At age 6–8 years: V was 52.5% of its final size in girls and 44.9% in boys; Pe was 80.2% its final length in girls and 76.8% in boys; St reached 68% of its final size in girls and 66.9% in boys; Tle reached 73.3% of its final length in girls and 71.2% in boys. At skeletal maturity, thoracic cage volume in boys was 19.4% greater than in girls (p < 0.05). AP/TD ratio remained < 1 in all age groups and did not differ between genders (p > 0.05).


Growth of the thoracic cage is shown to be a gradual process that is more linear than previously reported. Only small increases in annual growth rates were observed during the pubertal growth spurt. The most important events characterizing thoracic cage development occurred during the first few years of postnatal growth. The circular cross-section of the very young child’s thorax reached adult-like proportions together with its ovoid shape before age 6 years.


Thoracic cage Dimensions Volume Perimeter Diameter Growth 


Compliance with ethical standards

Conflict of interest

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

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Institutional review board approval (Comité Consultatif de Protection des Personnes se Prêtant a des Recherches Biomédicales—Montpellier St. Eloi, France; ref. CPPRB 060701) was obtained for this prospective study. Informed consent for participation in the study was obtained from participants or, where participants are children, a parent or guardian.


  1. 1.
    Bastir M, Garcia Martinez D, Recheis W et al (2013) Differential growth and development of the upper and lower human thorax. PLoS One 8(9):e75128. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Bellamare F, Jeanneret A, Couture J (2003) Sex differences in thoracic dimensions and configurations. Am J Respir Crit Care Med 168:305–312CrossRefGoogle Scholar
  3. 3.
    Butler JP, Loring S, Patz S et al (2012) Evidence for adult lung growth in adults. N Engl J Med 367:244–247. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Campbell RM, Smith MD, Mayes TC et al (2003) The characteristics of thoracic insufficiency associated with fused ribs and congenital scoliosis. J Bone Jt Surg Am 85:409–420CrossRefGoogle Scholar
  5. 5.
    Canavese F, Dimeglio A, Granier M et al (2007) Arthrodesis of the first six dorsal vertebrae in prepubertal New Zealand White rabbits and thoracic growth to skeletal maturity: the role of the “rib–vertebral–sternal complex”. Minerva Ortop Traumatol 58:369–378Google Scholar
  6. 6.
    Canavese F, Dimeglio A, Volpatti D et al (2007) Dorsal arthrodesis of thoracic spine and effects on thorax growth in prepubertal New Zealand White rabbits. Spine 32:E443–E450. CrossRefPubMedGoogle Scholar
  7. 7.
    Canavese F, Dimeglio A. Frontier of the impossible. In: Nnadi C (ed) Early onset scoliosis. Thieme, Hamburg, pp 2–9Google Scholar
  8. 8.
    Charles YP, Dimeglio A, Marcoul M, Bourgin JF, Marcoul A, Bozonnat MC (2008) Volumetric thoracic growth in children with moderate and severe scoliosis compared to subjects without spinal deformity. Stud Health Technol Inf 140:22–28Google Scholar
  9. 9.
    Charles YP, Diméglio A, Marcoul M, Bourgin JF, Marcoul A, Bozonnat MC (2008) Influence of idiopathic scoliosis on three-dimensional thoracic growth. Spine 33:1209–1218. CrossRefPubMedGoogle Scholar
  10. 10.
    Cottalorda J, Kohler R, Garin C, Lecante P (1997) Orthopedic treatment of scoliosis: new technique using impression by optic procedure. Arch Pediatr 4:464–467 (French)CrossRefPubMedGoogle Scholar
  11. 11.
    Dansereau J, Stokes IAF (1988) Measurements of the three dimensional shape of the rib cage. J Biomech 21:893–901CrossRefPubMedGoogle Scholar
  12. 12.
    Davenport CCB (1934) Thoracic index. Hum Biol 6:1–8Google Scholar
  13. 13.
    Dean J, Kohler R, Schleien C et al (1987) Age-related changes in chest geometry during cardiopulmonary resuscitation. J Appl Physiol 62:2212–2219CrossRefPubMedGoogle Scholar
  14. 14.
    Dimeglio A (2001) Growth in pediatric orthopedics. J Pediatr Orthop 21:549–555PubMedGoogle Scholar
  15. 15.
    Dimeglio A, Bonnel F (1990) Le rachis en croissance. Springer, ParisGoogle Scholar
  16. 16.
    Dimeglio A, Canavese F (2012) The growing spine: how spinal deformities influence normal spine and thoracic cage growth. Eur Spine J 21:64–70. CrossRefPubMedGoogle Scholar
  17. 17.
    Dreimann M, Hoffmann M, Kossow K et al (2014) 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 39:2024–2033. CrossRefPubMedGoogle Scholar
  18. 18.
    Dubousset J, Wicart P, Pomero V, Barois A, Estournet B (2003) Spinal penetration index: new three-dimensional quantified reference for lordoscoliosis and other spinal deformities. J Orthop Sci 8:41–49. CrossRefPubMedGoogle Scholar
  19. 19.
    Emrani M, Kirdeikis R, Igwe P, Hill D, Adeeb S (2009) Surface reconstruction of torsos with and without scoliosis. J Biomech 42:2200–2204. CrossRefPubMedGoogle Scholar
  20. 20.
    Goldberg CJ, Gillic I, Connaughton O et al (2003) Respiratory function and cosmesis at maturity in infantile-onset scoliosis. Spine 28:2397–2406. CrossRefPubMedGoogle Scholar
  21. 21.
    Ilharreborde B, Dubousset J, Le Huec JC (2014) Use of EOS imaging for the assessment of scoliosis deformities: application to postoperative 3D quantitative analysis of the trunk. Eur Spine J 23(Suppl 4):S397–S405. PubMedGoogle Scholar
  22. 22.
    Kangarloo H (1988) Chest MRI in children. Radiol Clin N Am 26:263–275PubMedGoogle Scholar
  23. 23.
    Karol LA, Johston C, Mladenov K et al (2008) Pulmonary function following early thoracic fusion in non neuromuscular scoliosis. J Bone Jt Surg Am 90:1272–1281. CrossRefGoogle Scholar
  24. 24.
    Kohler R, Cottalorda J, Garin C, Genevois P, Lecante P, Berge B (2005) Orthosis for mild scoliosis: a prospective study comparing traditional plaster mold manufacturing with fast, noncontact, 3-dimensional acquisition. Spine 30:399–405CrossRefPubMedGoogle Scholar
  25. 25.
    Kumar A, Ajemba P, Durdle N, Raso J (2006) Pre-processing range data for the analysis of torso shape and symmetry of scoliosis patients. Stud Health Technol Inform 123:483–487PubMedGoogle Scholar
  26. 26.
    Mehta HP, Snyder BD, Callender NN et al (2006) The reciprocal relationship between thoracic and spinal deformity and its effect on pulmonary function in a rabbit model: a pilot study. Spine 31:2654–2664. CrossRefPubMedGoogle Scholar
  27. 27.
    Narayanan M, Owers-Bradley J, Beardsmore CS et al (2012) Alveolarization continues during childhood and adolescence: new evidence from Helium-3 magnetic resonance. Am J Respir Crit Care Med 185:186–191. CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Oppenshaw P, Edwards S, Helms P (1984) Changes in rib cage geometry during childhood. Thorax 39:624–627CrossRefGoogle Scholar
  29. 29.
    Poncet P, Delorme S, Ronsky JL et al (2000) Reconstruction of laser-scanned 3D torso topography and stereoradiographical spine and rib-cage geometry in scoliosis. Comput Methods Biomech Biomed Eng 4:59–75CrossRefGoogle Scholar
  30. 30.
    Porto F, Gurgel JL, Russomano T, Farinatti Pde T (2010) Moiré topography: characteristics and clinical application. Gait Posture 32:422–424. CrossRefPubMedGoogle Scholar
  31. 31.
    Romei M, Mauro AL, D’Angelo MG, Turconi AC, Bresolin N et al (2010) Effects of gender and posture on thoraco abdominal kinematics during quiet breathing in healthy adults. Respir Physiol Neurobiol 172:184–191. CrossRefPubMedGoogle Scholar
  32. 32.
    Shi X, Cao L, Reed MP, Rupp JD, Hoff CN, Hu J (2014) A statistical human rib cage geometry model accounting for variations by age, sex, stature and body mass index. J Biomech 18:2277–2285. CrossRefGoogle Scholar
  33. 33.
    Swank SM, Winter RB, Moe JH (1982) Scoliosis and cor pulmonale. Spine 7:343–354CrossRefPubMedGoogle Scholar
  34. 34.
    Thurlbeck WM (1982) Postnatal human lung growth. Thorax 37:564–571CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Weaver AA, Schoell SL, Stitzel JD (2014) Morphometric analysis of variation in the ribs with age and sex. J Anat 225:246–261. CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Wilson TA, Rehder K, Krayer S, Hoffman EA, Whitney CG, Rodarte JR (1987) Geometry and respiratory displacement of human ribs. J Appl Physiol 62:1872–1877. CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Federico Canavese
    • 1
    • 6
    Email author
  • Alain Dimeglio
    • 2
  • François Bonnel
    • 2
  • Marco Corradin
    • 1
  • Bruno Pereira
    • 3
  • Amélie Marcoul
    • 4
  • Yann Philippe Charles
    • 5
  1. 1.Service de Chirurgie InfantileCHU Estaing Clermont-FerrandClermont-FerrandFrance
  2. 2.Faculté de MédicineUniversité de MontpellierMontpellierFrance
  3. 3.Marcenac-DucrosMontpellierFrance
  4. 4.Biostatistics Unit (DRCI)CHU Clermont-FerrandClermont-FerrandFrance
  5. 5.Service de Chirurgie du RachisHôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS)Strasbourg CedexFrance
  6. 6.Pediatric Surgery DepartmentUniversity Hospital EstaingClermont-FerrandFrance

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