Computed tomography-based bronchial tree three-dimensional reconstruction and airway resistance evaluation in adolescent idiopathic scoliosis

Wang, Juehan; Zhou, Bangjian; Yang, Xi; Zhou, Chunguang; Ling, Tingxian; Hu, Bowen; Song, Yueming; Liu, Limin

doi:10.1007/s00586-020-06383-x

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…Reconstruction of the trachea might be required if severe tracheal stenosis is diagnosed. Dedicated preparation, including appropriate tube selection and bronchoscopic evaluation prior to intubation, according to the indications of tracheal stenosis morphology has been suggested before anesthesia in patients with tracheal stenosis 5 . Once resistance is encountered during insertion of an appropriate size tube, flexible bronchoscopy should be performed instead of multiple attempted intubations.…”

Section: Discussionmentioning

confidence: 99%

Unsuspected severe tracheal stenosis and tracheomalacia after correction surgery for congenital scoliosis: A case report

Wang

Guan

et al. 2022

Pediatric Anesthesia

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Tracheal stenosis and tracheomalacia in patients with congenital scoliosis are serious and rare conditions caused by congenital dysplasia, postintubation injury, trauma, and tracheal tumor. Anesthesia of a child with tracheal stenosis is challenging for anesthesiologists. We describe an 8‐year‐old female patient developed severe tracheal stenosis and tracheomalacia after growing rod implantation for congenital scoliosis. Comprehensive assessment of preoperative pulmonary function and airway morphology, which can be neglected clinically, should be performed in congenital scoliosis patients.

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Section: Discussionmentioning

confidence: 99%

Unsuspected severe tracheal stenosis and tracheomalacia after correction surgery for congenital scoliosis: A case report

Wang

Guan

et al. 2022

Pediatric Anesthesia

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“…The restriction is thought to be secondary to chest wall deformity, reduced chest wall compliance, and respiratory muscle weakness 6-8,17,30,31 . However, in patients with thoracic AIS scheduled for a surgical procedure, the prevalence of obstructive lung disease is 21% to 39% 2,10,32 . In obstructive lung disease, expiration ends prematurely, causing a larger reduction of FEV 1 relative to FVC, resulting in low FEV 1 /FVC 29 .…”

Section: Discussionmentioning

confidence: 99%

Thoracic Morphology and Bronchial Narrowing Are Related to Pulmonary Function in Adolescent Idiopathic Scoliosis

Farrell

Garrido

Vavruch

et al. 2021

Journal of Bone and Joint Surgery

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Background:In adolescent idiopathic scoliosis (AIS), lung function impairment is not necessarily related to the coronal spinal deformity. Recently, right-sided bronchial narrowing has been reported in thoracic AIS. The aim of this study was to describe the relation of chest and spinal deformity parameters, bronchial narrowing, and lung volumes with pulmonary function in preoperative AIS.Methods:Spinal radiographs, low-dose computed tomographic (CT) scans of the spine including the chest, and pulmonary function tests were retrospectively collected for 85 preoperative patients with thoracic AIS in 2 centers and were compared with 14 matched controls. Three-dimensional lung and airway reconstructions were acquired. Correlation analysis was performed in which radiographic spinal parameters, CT-based thoracic deformity parameters (rib-hump index [RHi], spinal penetration index, endothoracic hump ratio, hemithoracic-width ratio), lung volume asymmetry, and bronchial cross-sectional area were compared with percent-of-predicted spirometry results.Results:Forty-one patients (48%) had a percent-of-predicted forced expiratory volume in 1 second (FEV1%) or percent-of-predicted forced vital capacity (FVC%) of <65%, and 17 patients (20%) had obstructive lung disease. All thoracic deformity parameters correlated significantly with FEV1% and FVC%; RHi was found to be the best correlate (rs = −0.52 for FEV1% and −0.54 for FVC%). Patients with AIS with impaired pulmonary function had hypokyphosis, a larger rib hump, increased spinal and thoracic rotation, a narrower right hemithorax, and increased intrusion of the spine into the chest. Spinal intrusion correlated with right-sided bronchial narrowing, relative right lung volume loss, and decreased FEV1% and FVC%. Multivariate regression including spinal and thoracic deformity parameters, lung volume asymmetry, and airway parameters could explain 57% of the variance in FEV1% and 54% of the variance in FVC%.Conclusions:Chest intrusion by the endothoracic hump is related to right-sided bronchial narrowing and lung function loss in preoperative AIS. The findings support the theory that ventilatory dysfunction in thoracic AIS is not only restrictive but frequently has an obstructive component, especially in patients with hypokyphosis. RHi is the most predictive chest parameter for lung function loss.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Pulmonary function in patients with adolescent idiopathic scoliosis: an explorative study of a wearable smart shirt as a measurement instrument

Te Hennepe,

Steegh,

Pouw

et al. 2024

Spine Deform

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Purpose Adolescent idiopathic scoliosis (AIS) presents various challenges, including respiratory symptoms that impact pulmonary function. This study aims to explore the feasibility of using a smart shirt for continuous monitoring of lung volumes and heart rate during routine activities in AIS patients. Methods A single-center exploratory feasibility study was conducted with AIS patients aged 16–22 years with a thoracic curvature of ≥ 30 degrees and absence of respiratory comorbidities. A smart shirt was utilized to continuously monitor cardiopulmonary parameters during mild exercise, which included a standardized walking route with the ascent of multiple stairs. Results Five participants completed the study. Baseline spirometry measurements showed a range of values for forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio. During mild exercise, participants exhibited variability in tidal volume, heart rate, breathing rate, and minute ventilation, with increases observed during stair climbing. Breathlessness levels also varied throughout the activity but did not correlate with the measured lung volumes. Overall, the use of the smart shirt for assessing pulmonary function in AIS patients was deemed feasible and well tolerated by participants during the test activities. Conclusion The study confirms the feasibility of using a smart shirt for continuous measurement of cardiopulmonary parameters in AIS patients during daily activities. Incongruities between spirometry results and perceived dyspnea exists, which questions the nature of the perceived dyspnea. Further research is needed to validate these findings and explore the impact of AIS characteristics on measurement accuracy.

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Computed tomography-based bronchial tree three-dimensional reconstruction and airway resistance evaluation in adolescent idiopathic scoliosis

Cited by 4 publications

References 20 publications

Unsuspected severe tracheal stenosis and tracheomalacia after correction surgery for congenital scoliosis: A case report

Unsuspected severe tracheal stenosis and tracheomalacia after correction surgery for congenital scoliosis: A case report

Thoracic Morphology and Bronchial Narrowing Are Related to Pulmonary Function in Adolescent Idiopathic Scoliosis

Pulmonary function in patients with adolescent idiopathic scoliosis: an explorative study of a wearable smart shirt as a measurement instrument

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