Prediction of respiratory function in patients with severe scoliosis on the basis of the novel individualized spino-pelvic index
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Our study aimed to evaluate the pulmonary function of patients with severe scoliosis after correcting standing height with spino-pelvic index (SPI).
Inclusion criteria: (1) with a coronal Cobb angle of more than 90°; (2) diagnosed as congenital (CS) or idiopathic scoliosis (IS); (3) aged between ten and 20 years; (4) with pulmonary function test (PFT) at the primary consultation. Patients with previous surgical intervention, with angular kyphosis, and with neuromuscular disease were excluded. Length of spine (LOS), height of spine (HOS), and height of pelvis (HOP) were measured on coronal films. SPI was defined as the ratio between LOS and HOP. The corrected body height was calculated: corrected body height = body height + (SPI × HOP − HOS). The PFTs included the following parameters: VCmax, FVC, FVC% predicted, FEV1, FEV1% predicted, PEF, and MVV. PFT results were recalculated using the corrected body height.
Thirty patients were diagnosed as IS and 27 as CS with average Cobb angles of 99.88° ± 11.83 and 98.06° ± 14.27, respectively. Significant differences were observed in VCmax and FVC between IS and CS patients (P < 0.05). All the corrected PFT parameters were significantly lower than the original PFT parameters (P < 0.05).
For the first time, this study proposed a method to predict pulmonary function of patients with severe scoliosis using SPI, as an age-independent parameter in normal adolescents. After body height correction, pulmonary function of patients with severe scoliosis was found to be significantly decreased, indicating that pulmonary function impairment was underestimated in patients with severe scoliosis when evaluating pulmonary function with arm span.
KeywordsScoliosis Pulmonary function Spino-pelvic index Spinal deformity
Compliance with ethical standards
All methods were performed in accordance with the relevant guidelines and regulations. Informed consent has been obtained from each participant in this study.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 2.Kim YJ, Lenke LG, Bridwell KH, Kim KL, Steger-May K (2005) Pulmonary function in adolescent idiopathic scoliosis relative to the surgical procedure. J Bone & Joint Surg 87(7):1534–1541Google Scholar
- 3.Payo J, Perez-Grueso FS, Fernandez-Baillo N, Garcia A (2009) Severe restrictive lung disease and vertebral surgery in a pediatric population. Euro Spine J : Off Pub Euro Spine Soc Euro Spinal Deformity Soc Euro Section Cervical Spine Res Soc 18(12):1905–1910. https://doi.org/10.1007/s00586-009-1084-8 CrossRefGoogle Scholar
- 7.Koller H, Zenner J, Gajic V, Meier O, Ferraris L, Hitzl W (2012) The impact of halo-gravity traction on curve rigidity and pulmonary function in the treatment of severe and rigid scoliosis and kyphoscoliosis: a clinical study and narrative review of the literature. Euro Spine J : Off Pub Euro Spine Soc Euro Spinal Deformity Soc Euro Section of the Cervical Spine Res Soc 21(3):514–529. https://doi.org/10.1007/s00586-011-2046-5 CrossRefGoogle Scholar
- 8.Dreimann M, Hoffmann M, Kossow K, Hitzl W, Meier O, Koller H (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 (Phila Pa 1976) 39(24):2024–2033. https://doi.org/10.1097/brs.0000000000000601 CrossRefGoogle Scholar
- 13.Tyrakowski M, Kotwicki T, Czubak J, Siemionow K (2014) Calculation of corrected body height in idiopathic scoliosis: comparison of four methods. Euro Spine J : Off Publ Euro Spine Soc Euro Spinal Deform Soc Euro Section of the Cervical Spine Res Soc 23(6):1244–1250. https://doi.org/10.1007/s00586-014-3275-1 CrossRefGoogle Scholar
- 16.Tay KS, Bassi A, Yeo W, Yue WM (2017) Associated lumbar scoliosis does not affect outcomes in patients undergoing focal minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) for neurogenic symptoms-a minimum 2-year follow-up study. Spine J : Off J North Am Spine Soc 17(1):34–43. https://doi.org/10.1016/j.spinee.2016.05.022 CrossRefGoogle Scholar
- 17.Chong HS, Padua MR, Kim JS, Lee HM, Moon SH, Suk KS, Hak Sun K (2015) Usefulness of noninvasive positive-pressure ventilation during surgery of flaccid neuromuscular scoliosis. J Spinal Disord Tech. https://doi.org/10.1097/bsd.0000000000000234
- 18.Nepple JJ, Lenke LG (2009) Severe idiopathic scoliosis with respiratory insufficiency treated with preoperative traction and staged anteroposterior spinal fusion with a 2-level apical vertebrectomy. Spine J : Off J North Am Spine Soc 9(7):e9–e13. https://doi.org/10.1016/j.spinee.2009.01.009 CrossRefGoogle Scholar
- 20.Emans JB, Ciarlo M, Callahan M, Zurakowski D (2005) Prediction of thoracic dimensions and spine length based on individual pelvic dimensions in children and adolescents: an age-independent, individualized standard for evaluation of outcome in early onset spinal deformity. Spine (Phila Pa 1976) 30(24):2824–2829CrossRefGoogle Scholar
- 21.Gold M, Dombek M, Miller PE, Emans JB, Glotzbecker MP (2014) Prediction of thoracic dimensions and spine length on the basis of individual pelvic dimensions: validation of the use of pelvic inlet width obtained by radiographs compared with computed tomography. Spine (Phila Pa 1976) 39(1):74–80. https://doi.org/10.1097/brs.0000000000000036 CrossRefGoogle Scholar
- 22.Glotzbecker M, Johnston C, Miller P, Smith J, Perez-Grueso FS, Woon R, Flynn J, Gold M, Garg S, Redding G, Cahill P, Emans J (2014) Is there a relationship between thoracic dimensions and pulmonary function in early-onset scoliosis? Spine (Phila Pa 1976) 39(19):1590–1595. https://doi.org/10.1097/brs.0000000000000449 CrossRefGoogle Scholar
- 24.Krege JH, Kendler D, Krohn K, Genant H, Alam J, Berclaz PY, Coffey B, Loghin C (2015) Relationship between vertebral fracture burden, height loss, and pulmonary function in postmenopausal women with osteoporosis. J Clin Densitometry : Off J Int Soci Cli Densitometry. https://doi.org/10.1016/j.jocd.2015.02.004