Understanding Respiratory Restrictions as a Function of the Scoliotic Spinal Curve in Thoracic Insufficiency Syndrome: A 4D Dynamic MR Imaging Study

Journal of Pediatric Orthopedics
Jayaram K UdupaRobert M Campbell

Abstract

Over the past 100 years, many procedures have been developed for correcting restrictive thoracic deformities which cause thoracic insufficiency syndrome. However, none of them have been assessed by a robust metric incorporating thoracic dynamics. In this paper, we investigate the relationship between radiographic spinal curve and lung volumes derived from thoracic dynamic magnetic resonance imaging (dMRI). Our central hypothesis is that different anteroposterior major spinal curve types induce different restrictions on the left and right lungs and their dynamics. Retrospectively, we included 25 consecutive patients with thoracic insufficiency syndrome (14 neuromuscular, 7 congenital, 4 other) who underwent vertical expandable prosthetic titanium rib surgery and received preimplantation and postimplantation thoracic dMRI for clinical care. We measured thoracic and lumbar major curves by the Cobb measurement method from anteroposterior radiographs and classified the curves as per Scoliosis Research Society (SRS)-defined curve types. From 4D dMRI images, we derived static volumes and tidal volumes of left and right lung, along with left and right chest wall and left and right diaphragm tidal volumes (excursions), and analyzed thei...Continue Reading

References

Apr 7, 2007·Journal of Pediatric Orthopedics·George H ThompsonRobert M Campbell
Sep 6, 2007·Journal of Digital Imaging·George GreveraShipra Mishra
Jun 4, 2008·The Journal of Bone and Joint Surgery. American Volume·Lori A KarolRichard H Browne
Jan 29, 2013·Scoliosis·Brandon B CarlsonMarc A Asher
Jan 17, 2014·Journal of Children's Orthopaedics·Wei ChenDoug Hill
Feb 13, 2016·Journal of Pediatric Orthopedics·Jennifer K WozniczkaDavid J Nuckley

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Citations

Feb 25, 2019·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Burt YaszayPeter O Newton
Jan 9, 2021·Computerized Medical Imaging and Graphics : the Official Journal of the Computerized Medical Imaging Society·Qi ZhangTerry M Peters

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