Purpose <p>Severe spinal curvature in early onset scoliosis (EOS) impairs pulmonary development and function. The treatment requires imaging to assess spine growth and pulmonary function. The purposes of this study were to determine if radiographic sagittal spinal length (SSL) correlates with pulmonary function testing (PFT) and to compare SSL with T1–T12 coronal height (CH) to guide definitive fusion in EOS patients.</p> Methods <p>Growth-friendly graduate EOS patients who underwent definitive spinal fusion and had postoperative PFT data were identified in a multi-center database. CH and SSL measurements were obtained from upright radiographs. The PFT results were compared between these measurements, using the percentage of the expected PFT value based on age, sex, and height (arm span).</p> Results <p>Forty-four patients were included. The average age at definitive fusion was 12.1&#xa0;years (range, 10 to 15) at a mean of 5.6&#xa0;years after the growth-friendly procedure. The diagnoses were idiopathic scoliosis (22/44, 50%), congenital scoliosis (12/44, 27%), syndromic scoliosis (8/44, 18%), and neuromuscular scoliosis (2/44, 5%). 37.2% of patients had moderate pulmonary dysfunction (FVCp &lt; 60%). SSL and CH were strongly correlated (<i>r</i> = 0.770, <i>p</i> &lt; 0.001). Predicted FEV1 and FVC had statistically significant moderate correlation with SSL (FEV1 <i>r</i> = 0.438, <i>p</i> = 0.002; FVC <i>r</i> = 0.450, <i>p</i> &lt; 0.001), and weak correlation with CH (FEV1 <i>r</i> = 0.207, <i>p</i> = 0.091; FVC <i>r</i> = 0.282, <i>p</i> = 0.033).</p> Conclusion <p>SSL strongly correlated with traditional CH measurements, averaging 10&#xa0;mm longer (<i>p</i> &lt; 0.001). SSL had a stronger correlation with PFT than traditional CH, suggesting that, by considering the sagittal plane, SSL may provide a better indicator than CH for determining the timing of definitive fusion in EOS patients.</p>

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Sagittal spine length moderately correlates with pulmonary function for the timing of definitive fusion in growth-friendly graduates with early onset scoliosis

  • Matthew B. Holloway,
  • Ron El-Hawary,
  • Todd F. Ritzman,
  • Alexandria N. Rundell,
  • Richard P. Steiner,
  • Amir Mishreky,
  • Jennifer K. Hurry,
  • Maeve Proto-Newton,
  • William Accousti,
  • Edward Ahn,
  • Behrooz Akbarnia,
  • Harry Akoto,
  • Stephen Albanese,
  • Jason Anari,
  • John Anderson,
  • Richard Anderson,
  • Lindsay Andras,
  • Carl-Eric Aubin,
  • Karl Balsara,
  • David Bauer,
  • Jennifer Bauer,
  • Eduardo Beauchamp,
  • Laura Bellaire,
  • James Bennett,
  • Randy Betz,
  • Craig Birch,
  • LaurelBlakemore,
  • Oheneba Boachie-Adjei,
  • Chris Bonfield,
  • Timoth Borden,
  • Daniel Bouton,
  • Bruno Braga,
  • Felix Brassard,
  • Douglas Brockmeyer,
  • Jaysson Brooks,
  • Aaron Buckland,
  • David Bumpass,
  • Rebecca Burke,
  • Pat Cahill,
  • Mark Camp,
  • Jeffrey Campbell,
  • Patrick Carry,
  • René Castelein,
  • Anthony Catanzano,
  • Olivier Chemaly,
  • Kenneth Cheung,
  • Jason Cheung,
  • Robert Cho,
  • Tyler Christman,
  • Carter Clement,
  • Daniel Couture,
  • Haemish Crawford,
  • Alvin Crawford,
  • John Dahl,
  • Benny Dahl,
  • Gokhan Demirkiran,
  • Dennis Devito,
  • Mohammad Diab,
  • Luke Drake,
  • Dan Drake,
  • Yehia El-Bromboly,
  • Ron El-Hawary,
  • John Emans,
  • Mark Erickson,
  • Katie Fehnel,
  • Antony Field,
  • Rolando Figueroa Roberto,
  • Ryan Fitzgerald,
  • Lorena Floccari,
  • Jack Flynn,
  • Peter Gabos,
  • Alejandro Peiro Garcia,
  • Adrian Gardner,
  • Sumeet Garg,
  • Stephen George,
  • Frank Gerow,
  • John Ghazi,
  • Michael Glotzbecker,
  • Jaime Gomez,
  • David Gonda,
  • Mari Groves,
  • Tenner Guillaume,
  • Purnendu Gupta,
  • Lawrence Haber,
  • Kim Hammerberg,
  • Christina Hardesty,
  • Daniel Hedequist,
  • Michael Heffernan,
  • Ilkka Helenius,
  • Jose Herrera,
  • Grant Hogue,
  • Josh Holt,
  • Jason Howard,
  • Tim Hresko,
  • Michael Hughes,
  • Steven Hwang,
  • Stephanie Ihnow,
  • Kenneth Illingworth,
  • Omar Iqbal,
  • Rajiv Iyer,
  • Viral Jain,
  • Andrew Jea,
  • Megan Johnson,
  • Charles Johnston,
  • Morgan Jones,
  • Allen Kadado,
  • Alexa Karkenny,
  • Judson Karlen,
  • Lawrence Karlin,
  • Noriaki Kawakami,
  • Brian Kelly,
  • Derek Kelly,
  • Michael Kelly,
  • Joshua Klatt,
  • Paul Koljonen,
  • Moyo Kruijt,
  • Kenny Kwan,
  • Hubert Labelle,
  • Matthew Landrum,
  • Robert Lark,
  • Noelle Larson,
  • William Lavelle,
  • Hai Le,
  • David Lebel,
  • Lawrence Lenke,
  • Sean Lew,
  • Ying Li,
  • Craig Louer,
  • Scott Luhmann,
  • Brett Lullo,
  • Jean-Marc Mac Thiong,
  • Stuart Mackenzie,
  • Erin MacKintosh,
  • Francesco Mangano,
  • David Marks,
  • Alejandro Jose Marquez-Lara,
  • Jonathan Martin,
  • Jeffrey Martus,
  • Smitha Mathew,
  • Hiroko Matsumoto,
  • Oscar Mayer,
  • Richard McCarthy,
  • Amy McIntosh,
  • Jessica McQuerry,
  • Jwalant Mehta,
  • Bryan Menapace,
  • Lionel Metz,
  • Kyle Miller,
  • Daniel Miller,
  • Nancy Miller,
  • Stuart Mitchell,
  • Firoz Miyanji,
  • Blake Montgomery,
  • Kevin Morash,
  • Greg Mundis,
  • Josh Murphy,
  • Robert Murphy,
  • Susan Nelson,
  • Peter Newton,
  • Matthew Newton Ede,
  • Cynthia Nguyen,
  • Toba Niazi,
  • Susana Nunez Pereira,
  • Matthew Oetgen,
  • Taimin Oh,
  • Keith Orland,
  • Jean Ouellet,
  • Josh Pahys,
  • Stefan Parent,
  • Ferran Pellise,
  • Francisco Perez-Grueso,
  • Joseph Perra,
  • Javier Pizones,
  • Stephen Plachta,
  • Selina Poon,
  • Nigel Price,
  • Aki Puryear,
  • Subaraman Ramchandran,
  • Norman Ramirez,
  • Brandon Ramo,
  • Gregory Redding,
  • Todd Ritzman,
  • Luis Rodriguez,
  • Juan Rodriguez-Olaverri,
  • David Roye,
  • Benjamin Roye,
  • Paul Rushton,
  • Amer Samdani,
  • Jose Miguel Sanchez Marquez,
  • James Sanders,
  • Jeffrey Sawyer,
  • Christina Sayama,
  • Michael Schmitz,
  • Jacob Schulz,
  • Richard Schwend,
  • Anand Segar,
  • Suken Shah,
  • Brett Shannon,
  • Aaron Shaw,
  • Graham Shea,
  • Otis Shirley,
  • Harry Shufflebarger,
  • Andrea Simmonds,
  • David Skaggs,
  • Timothy Skalak,
  • Kevin Smit,
  • John Smith,
  • Brian Snyder,
  • Joshua Speirs,
  • Paul Sponseller,
  • Carl St. Remy,
  • Joe Stone,
  • Peter Sturm,
  • Hamdi Sukkarieh,
  • Ishaan Swarup,
  • Michal Szczodry,
  • Tomoko Tanaka,
  • Tyler Tetreault,
  • John Thometz,
  • George Thompson,
  • Andrew Tice,
  • Walter Truong,
  • Dominick Tuason,
  • Joel Turtle,
  • Vidyadhar Upasani,
  • Sara Van Nortwick,
  • Raphael Vialle,
  • Michael Vitale,
  • John Vorhies,
  • Shengru Wang,
  • Bill Warner,
  • Stuart Weinstein,
  • Michelle Welborn,
  • Klane White,
  • Nichola Wilson,
  • David Wrubel,
  • Nan Wu,
  • Scott Yang,
  • Kwadwo Yankey,
  • Burt Yaszay,
  • Muharrem Yazici,
  • Terry Jianguo Zhang,
  • Lorena V. Floccari

摘要

Purpose

Severe spinal curvature in early onset scoliosis (EOS) impairs pulmonary development and function. The treatment requires imaging to assess spine growth and pulmonary function. The purposes of this study were to determine if radiographic sagittal spinal length (SSL) correlates with pulmonary function testing (PFT) and to compare SSL with T1–T12 coronal height (CH) to guide definitive fusion in EOS patients.

Methods

Growth-friendly graduate EOS patients who underwent definitive spinal fusion and had postoperative PFT data were identified in a multi-center database. CH and SSL measurements were obtained from upright radiographs. The PFT results were compared between these measurements, using the percentage of the expected PFT value based on age, sex, and height (arm span).

Results

Forty-four patients were included. The average age at definitive fusion was 12.1 years (range, 10 to 15) at a mean of 5.6 years after the growth-friendly procedure. The diagnoses were idiopathic scoliosis (22/44, 50%), congenital scoliosis (12/44, 27%), syndromic scoliosis (8/44, 18%), and neuromuscular scoliosis (2/44, 5%). 37.2% of patients had moderate pulmonary dysfunction (FVCp < 60%). SSL and CH were strongly correlated (r = 0.770, p < 0.001). Predicted FEV1 and FVC had statistically significant moderate correlation with SSL (FEV1 r = 0.438, p = 0.002; FVC r = 0.450, p < 0.001), and weak correlation with CH (FEV1 r = 0.207, p = 0.091; FVC r = 0.282, p = 0.033).

Conclusion

SSL strongly correlated with traditional CH measurements, averaging 10 mm longer (p < 0.001). SSL had a stronger correlation with PFT than traditional CH, suggesting that, by considering the sagittal plane, SSL may provide a better indicator than CH for determining the timing of definitive fusion in EOS patients.