Evaluation of improved lung and airway morphology using CT 3D reconstruction after severe scoliosis correction: a...

Previous studies have not compared lung and airway morphologies before and after treatment for severe scoliosis. Herein, computed tomography (CT) 3-dimensional (3D) reconstruction of the respiratory system was performed to evaluate the changes in lung expansion and airway dilation following posterior spinal fusion for severe scoliosis.

Twenty-two patients with severe scoliosis (12 women and 10 men) who treated with posterior spinal fusion (PSF) were included. Pre- and postoperative visits included CT scans and radiographic assessments. Changes in airway dilation were assessed using 3D CT reconstruction of the bronchial tree, and changes in lung volume were evaluated using lung 3D CT reconstruction pre- and postoperatively.

Spinal radiographic parameters improved after PSF. The main Cobb angles were 135.89 ± 21.80° and 50.51 ± 16.02° (p < 0.001), and thoracic kyphosis angles were 115.75 ± 35.47° and 47.60 ± 8.56° in the pre- and postoperative groups, respectively (p < 0.001). After PSF, the total lung volume (TLV) values improved from 1.48 ± 0.76L to 1.89 ± 0.33 L, which were significantly different (t = 3.099, p = 0.0101). The preoperative and postoperative values for the left lung volume (0.69 ± 0.34 and 0.88 ± 0.33L) and right lung volume (0.69 ± 0.14 and 0.95 ± 0.28L) were significantly different [t = 3.802; p = 0.0029]; [t = 3.415; p = 0.0066]. The tracheal diameter varied between the pre- and postoperative groups (12.21 ± 1.91 mm vs. 15.32 ± 1.83 mm, respectively) (p < 0.0001). The diameter of the left main bronchus increased from 9.83 ± 2.41 mm to 12.01 ± 1.76 mm (p = 0.0138). The diameter of the right major bronchus increased from 9.88 ± 2.41 to 11.63 ± 1.37 mm (p = 0.0048).

Lung morphology parameters, including lobe volume and bronchial parameters, can be measured using CT-based reconstructions. PSF can safely and effectively correct the curve, relieve airway obstruction, and expand the lungs of patients with severe scoliosis.

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