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Estimating pulmonary function after surgery for adolescent idiopathic scoliosis using biplanar radiographs of the chest with 3D reconstruction

Article dans une revue avec comité de lecture
Author
PIETTON, Raphaël
413221 Sorbonne Université [SU]
BOULOUSSA, Houssam
360410 CHU Trousseau [APHP]
LANGLAIS, Tristan
413221 Sorbonne Université [SU]
TAYTARD, Jessica
360410 CHU Trousseau [APHP]
413221 Sorbonne Université [SU]
BEYDON, Nicole
413221 Sorbonne Université [SU]
ccSKALLI, Wafa
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
ccVERGARI, Claudio
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
VIALLE, Raphaël
360410 CHU Trousseau [APHP]
413221 Sorbonne Université [SU]

URI
http://hdl.handle.net/10985/21359
DOI
10.1302/0301-620x.104b1.bjj-2021-0337.r2
Date
2022
Journal
The Bone & Joint Journal (BJJ)

Abstract

Aims This study addressed two questions: first, does surgical correction of an idiopathic scoliosis increase the volume of the rib cage, and second, is it possible to evaluate the change in lung function after corrective surgery for adolescent idiopathic scoliosis (AIS) using biplanar radiographs of the ribcage with 3D reconstruction? Methods A total of 45 patients with a thoracic AIS which needed surgical correction and fusion were included in a prospective study. All patients underwent pulmonary function testing (PFT) and low-dose biplanar radiographs both preoperatively and one year after surgery. The following measurements were recorded: forced vital capacity (FVC), slow vital capacity (SVC), and total lung capacity (TLC). Rib cage volume (RCV), maximum rib hump, main thoracic curve Cobb angle (MCCA), medial-lateral and anteroposterior diameter, and T4-T12 kyphosis were calculated from 3D reconstructions of the biplanar radiographs. Results All spinal and thoracic measurements improved significantly after surgery (p < 0.001). RCV increased from 4.9 l (SD 1) preoperatively to 5.3 l (SD 0.9) (p < 0.001) while TLC increased from 4.1 l (SD 0.9) preoperatively to 4.3 l (SD 0.8) (p < 0.001). RCV was correlated with all functional indexes before and after correction of the deformity. Improvement in RCV was weakly correlated with correction of the mean thoracic Cobb angle (p = 0.006). The difference in TLC was significantly correlated with changes in RCV (p = 0.041). It was possible to predict postoperative TLC from the postoperative RCV. Conclusion 3D rib cage assessment from biplanar radiographs could be a minimally invasive method of estimating pulmonary function before and after spinal fusion in patients with an AIS. The 3D RCV reflects virtual chest capacity and hence pulmonary function in this group of patients.

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