Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography

Nobuyuki Fujita, Mitsuru Yagi, Takehiro Michikawa, Yoshitake Yamada, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Eijiro Okada, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe

研究成果: Article

抄録

Purpose: Although lung volume (LV) can be measured directly by computed tomography (CT), the literature regarding CT-assessed LV in adolescent idiopathic scoliosis (AIS) patients is limited, and the influence of posterior spinal fusion with instrumentation (PSF) on LV has not been established. This study aimed to identify factors associated with decreased LV after PSF in AIS patients. Methods: We retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20 years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysis. Results: The mean total LV had increased at the 2-year follow-up, although marginally significant (p =.06), and there was a significant increase in the left LV (p =.01) but not the right LV (p =.25). We observed a postoperative reduction in total LV, defined as a total LV postoperative/preoperative ratio < 0.9, in 20 of the 111 patients (18.0%). Univariable analysis showed a significant correlation between ≥ 11 fusion levels and postoperative LV reduction (OR 3.11, 95% CI 1.13–8.57). This factor remained significant in the multivariable analysis, which yielded an adjusted OR of 2.82 (95% CI 1.01–7.93) for postoperative LV reduction in patients with ≥ 11 fusion levels. Conclusion: Our data suggest that a longer fusion area is associated with postoperative LV reduction. Therefore, avoidance of a longer fusion area of ≥ 11 will be preferable for preserving LV. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

元の言語English
ページ(範囲)2034-2041
ページ数8
ジャーナルEuropean Spine Journal
28
発行部数9
DOI
出版物ステータスPublished - 01-09-2019

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Scoliosis
Tomography
Lung
Pneumonectomy
Spinal Fusion
Respiratory Function Tests
Body Weight

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

これを引用

Fujita, N., Yagi, M., Michikawa, T., Yamada, Y., Suzuki, S., Tsuji, O., ... Watanabe, K. (2019). Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography. European Spine Journal, 28(9), 2034-2041. https://doi.org/10.1007/s00586-019-06025-x
Fujita, Nobuyuki ; Yagi, Mitsuru ; Michikawa, Takehiro ; Yamada, Yoshitake ; Suzuki, Satoshi ; Tsuji, Osahiko ; Nagoshi, Narihito ; Okada, Eijiro ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Watanabe, Kota. / Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography. :: European Spine Journal. 2019 ; 巻 28, 番号 9. pp. 2034-2041.
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title = "Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography",
abstract = "Purpose: Although lung volume (LV) can be measured directly by computed tomography (CT), the literature regarding CT-assessed LV in adolescent idiopathic scoliosis (AIS) patients is limited, and the influence of posterior spinal fusion with instrumentation (PSF) on LV has not been established. This study aimed to identify factors associated with decreased LV after PSF in AIS patients. Methods: We retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20 years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysis. Results: The mean total LV had increased at the 2-year follow-up, although marginally significant (p =.06), and there was a significant increase in the left LV (p =.01) but not the right LV (p =.25). We observed a postoperative reduction in total LV, defined as a total LV postoperative/preoperative ratio < 0.9, in 20 of the 111 patients (18.0{\%}). Univariable analysis showed a significant correlation between ≥ 11 fusion levels and postoperative LV reduction (OR 3.11, 95{\%} CI 1.13–8.57). This factor remained significant in the multivariable analysis, which yielded an adjusted OR of 2.82 (95{\%} CI 1.01–7.93) for postoperative LV reduction in patients with ≥ 11 fusion levels. Conclusion: Our data suggest that a longer fusion area is associated with postoperative LV reduction. Therefore, avoidance of a longer fusion area of ≥ 11 will be preferable for preserving LV. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].",
author = "Nobuyuki Fujita and Mitsuru Yagi and Takehiro Michikawa and Yoshitake Yamada and Satoshi Suzuki and Osahiko Tsuji and Narihito Nagoshi and Eijiro Okada and Takashi Tsuji and Masaya Nakamura and Morio Matsumoto and Kota Watanabe",
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Fujita, N, Yagi, M, Michikawa, T, Yamada, Y, Suzuki, S, Tsuji, O, Nagoshi, N, Okada, E, Tsuji, T, Nakamura, M, Matsumoto, M & Watanabe, K 2019, 'Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography', European Spine Journal, 巻. 28, 番号 9, pp. 2034-2041. https://doi.org/10.1007/s00586-019-06025-x

Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography. / Fujita, Nobuyuki; Yagi, Mitsuru; Michikawa, Takehiro; Yamada, Yoshitake; Suzuki, Satoshi; Tsuji, Osahiko; Nagoshi, Narihito; Okada, Eijiro; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Watanabe, Kota.

:: European Spine Journal, 巻 28, 番号 9, 01.09.2019, p. 2034-2041.

研究成果: Article

TY - JOUR

T1 - Impact of fusion for adolescent idiopathic scoliosis on lung volume measured with computed tomography

AU - Fujita, Nobuyuki

AU - Yagi, Mitsuru

AU - Michikawa, Takehiro

AU - Yamada, Yoshitake

AU - Suzuki, Satoshi

AU - Tsuji, Osahiko

AU - Nagoshi, Narihito

AU - Okada, Eijiro

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Watanabe, Kota

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: Although lung volume (LV) can be measured directly by computed tomography (CT), the literature regarding CT-assessed LV in adolescent idiopathic scoliosis (AIS) patients is limited, and the influence of posterior spinal fusion with instrumentation (PSF) on LV has not been established. This study aimed to identify factors associated with decreased LV after PSF in AIS patients. Methods: We retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20 years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysis. Results: The mean total LV had increased at the 2-year follow-up, although marginally significant (p =.06), and there was a significant increase in the left LV (p =.01) but not the right LV (p =.25). We observed a postoperative reduction in total LV, defined as a total LV postoperative/preoperative ratio < 0.9, in 20 of the 111 patients (18.0%). Univariable analysis showed a significant correlation between ≥ 11 fusion levels and postoperative LV reduction (OR 3.11, 95% CI 1.13–8.57). This factor remained significant in the multivariable analysis, which yielded an adjusted OR of 2.82 (95% CI 1.01–7.93) for postoperative LV reduction in patients with ≥ 11 fusion levels. Conclusion: Our data suggest that a longer fusion area is associated with postoperative LV reduction. Therefore, avoidance of a longer fusion area of ≥ 11 will be preferable for preserving LV. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

AB - Purpose: Although lung volume (LV) can be measured directly by computed tomography (CT), the literature regarding CT-assessed LV in adolescent idiopathic scoliosis (AIS) patients is limited, and the influence of posterior spinal fusion with instrumentation (PSF) on LV has not been established. This study aimed to identify factors associated with decreased LV after PSF in AIS patients. Methods: We retrospectively reviewed 111 consecutive AIS patients who were between 10 and 20 years of age and were treated by PSF at our facility. We assessed age at surgery, sex, height, body weight, Risser stage, Lenke classification, radiographic parameters, pulmonary function tests, and LV. Factors associated with a postoperative decrease in LV were identified by multivariable analysis. Results: The mean total LV had increased at the 2-year follow-up, although marginally significant (p =.06), and there was a significant increase in the left LV (p =.01) but not the right LV (p =.25). We observed a postoperative reduction in total LV, defined as a total LV postoperative/preoperative ratio < 0.9, in 20 of the 111 patients (18.0%). Univariable analysis showed a significant correlation between ≥ 11 fusion levels and postoperative LV reduction (OR 3.11, 95% CI 1.13–8.57). This factor remained significant in the multivariable analysis, which yielded an adjusted OR of 2.82 (95% CI 1.01–7.93) for postoperative LV reduction in patients with ≥ 11 fusion levels. Conclusion: Our data suggest that a longer fusion area is associated with postoperative LV reduction. Therefore, avoidance of a longer fusion area of ≥ 11 will be preferable for preserving LV. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.].

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