title: Pulmonary function tests correlated with thoracic volumes in adolescent idiopathic scoliosis.
abstract: Scoliosis deformity has been linked with deleterious changes in the thoracic cavity that affect pulmonary function. The causal relationship between spinal deformity and pulmonary function has yet to be fully defined. It has been hypothesized that deformity correction improves pulmonary function by restoring both respiratory muscle efficiency and increasing the space available to the lungs. This research aims to correlate pulmonary function and thoracic volume before and after scoliosis correction. Retrospective correlational analysis between thoracic volume modeling from plain x-rays and pulmonary function tests was conducted. Adolescent idiopathic scoliosis patients enrolled in a multicenter database were sorted by pre-operative Total Lung Capacities (TLC) % predicted values from their Pulmonary Function Tests (PFT). Ten patients with the best and ten patients with the worst TLC values were included. Modeled thoracic volume and TLC values were compared before and 2 years after surgery. Scoliosis correction resulted in an increase in the thoracic volume for patients with the worst initial TLCs (11.7%) and those with the best initial TLCs (12.5%). The adolescents with the most severe pulmonary restriction prior to surgery strongly correlated with post-operative change in total lung capacity and thoracic volume (r2= 0.839; p < 0.001). The mean increase in thoracic volume in this group was 373.1 cm3(11.7%) which correlated with a 21.2% improvement in TLC. Scoliosis correction in adolescents was found to increase thoracic volume and is strongly correlated with improved TLC in cases with severe restrictive pulmonary function, but no correlation was found in cases with normal pulmonary function. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:175-182, 2017.
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Minneapolis 55454, Minnesota.
authors.forename: Charles Gerald T
authors.initials: CG
authors.lastname: Ledonio
authors.affiliation: Medical School, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Benjamin E
authors.initials: BE
authors.lastname: Rosenstein
authors.affiliation: Department of Pediatric Orthopedic Surgery, Texas Scottish Rite Hospital for Children, Dallas, Texas.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Johnston
authors.affiliation: Department of Pediatrics-Pediatric Pulmonology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Warren E
authors.initials: WE
authors.lastname: Regelmann
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Minneapolis 55454, Minnesota.|Zimmer Spine, Minneapolis, Minnesota.
authors.forename: David J
authors.initials: DJ
authors.lastname: Nuckley
authors.affiliation: Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue South, Minneapolis 55454, Minnesota.
authors.forename: David W
authors.initials: DW
authors.lastname: Polly
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012600:Scoliosis / Q000503:physiopathology* / Q000601:surgery; D013909:Thorax / Q000033:anatomy & histology; D055815:Young Adult
keywords: adolescent idiopathic scoliosis; deformity; modeling; pulmonary function test; scoliosis correction; thoracic volume; total lung capacity