Assessment of the respiratory system in children with congenital scoliosis by impulse oscillometry and computed tomography (preliminary results)

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Abstract

BACKGROUND: Segmentation disorder of the vertebral body lateral surfaces and rib synostosis are severe variants of congenital pathology of the spine and thorax. They lead to the development of thoracic insufficiency syndrome and are manifested by the inability of the thorax to provide normal respiratory mechanics.

AIM: This study presents the preliminary results of functional and radiological (CT-morphometric) methods of lung examinations in patients with congenital thoracic spine scoliosis with impaired segmentation of the lateral surfaces of the vertebral bodies and unilateral rib synostosis.

MATERIALS AND METHODS: This design is represented by a small clinical series. This study is a prospective study of 10 patients aged 3 to 7 years with congenital spinal deformity, with impaired segmentation of the lateral surfaces of vertebral bodies and unilateral rib synostosis. This paper presents the preliminary results of the pulmonary function assessment by pulse oscillometry and CT morphometry in a 3D reconstruction of multispiral computer tomography (MSCT) of the thorax.

RESULTS: The study of respiratory function using pulse oscillometry revealed no respiratory impairment in seven observations, also reflected in the CT morphometry results. According to the Institute of Medicine (IOM), three children with detected ventilatory abnormalities showed the following parameters with the most significant changes: total respiratory impedance, resonance frequency, and frequency dependence of the resistive component. In all patients, the morphometric indexes of the lung scoring revealed during 3D modeling of the lung were completely consistent with the results of the lung function study by the IOM method.

CONCLUSIONS: Further study of the problem of respiratory function assessment in children with congenital scoliosis seems promising in diagnostic terms and for evaluating effective surgical treatment.

About the authors

Sergei V. Vissarionov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN-code: 7125-4930
Scopus Author ID: 6504128319
ResearcherId: P-8596-2015

MD, PhD, D.Sc., Professor, Corresponding Member of RAS

Russian Federation, Saint Petersburg

Marat S. Asadulaev

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Author for correspondence.
Email: marat.asadulaev@yandex.ru
ORCID iD: 0000-0002-1768-2402
SPIN-code: 3336-8996
Scopus Author ID: 57191618743

MD, PhD student

Russian Federation, Saint Petersburg

Elena A. Orlova

Children’s municipal multi-specialty clinical center of high medical technology named after K.A. Rauhfus

Email: eaorlova65@mail.ru
ORCID iD: 0000-0002-3128-980X

MD, PhD, Cand. Sci. (Med.), doctor of functional diagnostics

Russian Federation, Saint Petersburg

Vachtang G. Toriya

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: vakdiss@yandex.ru
ORCID iD: 0000-0002-2056-9726
SPIN-code: 1797-5031

MD, neurosurgeon

Russian Federation, Saint Petersburg

Kirill A. Kartavenko

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: med-kart@yandex.ru
ORCID iD: 0000-0002-6112-3309
SPIN-code: 5341-4492
Scopus Author ID: 57193272063

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint-Petersburg

Timofey S. Rybinskikh

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: timofey1999r@gmail.com
ORCID iD: 0000-0002-4180-5353
SPIN-code: 7739-4321

6th year student

Russian Federation, Saint Petersburg

Tatyana V. Murashko

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: popova332@mail.ru
ORCID iD: 0000-0002-0596-3741
SPIN-code: 9295-6453

MD, radiologist

Russian Federation, Saint Petersburg

Mikhail A. Khardikov

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: denica1990@bk.ru
ORCID iD: 0000-0002-8269-0900
SPIN-code: 3378-7685
Scopus Author ID: 57203014683

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Dmitry N. Kokushin

H. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery

Email: partgerm@yandex.ru
ORCID iD: 0000-0002-2510-7213
SPIN-code: 9071-4853
Scopus Author ID: 57193257768

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

References

  1. McMaster MJ, McMaster ME. Prognosis for congenital scoliosis due to a unilateral failure of vertebral segmentation. J Bone Joint Surg Am. 2013;95(11):972–979. doi: 10.2106/JBJS.L.01096
  2. Winter RB. Congenital thoracic scoliosis with unilateral unsegmented bar, convex hemivertebrae, and fused concave ribs with severe progression after posterior fusion at age 2. Spine. 2012;37(8):E507–E510. doi: 10.1097/BRS.0b013e31824ac401
  3. Mihajlovskij MV, Suzdalov VA. Sindrom torakal’noj nedostatochnosti pri infantil’nom vrozhdennom skolioze. Hirurgija pozvonochnika. 2010;(3):20–28. (In Russ.). doi: 10.14531/ss2010.3.20-28
  4. Campbell RM Jr, Smith MD. Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am. 2007;89(Suppl 1):108–122. doi: 10.2106/JBJS.F.00270
  5. Mayer O, Campbell R, Cahill P, Redding G. Thoracic insufficiency syndrome. Curr Probl Pediatr Adolesc Health Care. 2016;46(3):72–97. doi: 10.1016/j.cppeds.2015.11.001
  6. Tong Y, Udupa JK, McDonough JM, et al. Quantitative dynamic thoracic MRI: Application to thoracic insufficiency syndrome in pediatric patients. Radiology. 2019;292(1):206–213. doi: 10.1148/radiol.2019181731
  7. Vissarionov SV, Husainov NO, Kokushin DN. Analiz rezul’tatov hirurgicheskogo lechenija detej s mnozhestvennymi anomalijami razvitija pozvonkov i grudnoj kletki s ispol’zovaniem vnepozvonochnyh metallokonstrukcij. Ortopedija, travmatologija i vosstanovitel’naja hirurgija detskogo vozrasta. 2017;5(2):5–12. (In Russ.). doi: 10.17816/PTORS525
  8. Schlösser TPC, Kruyt MC, Tsirikos AI. Surgical management of early-onset scoliosis: indications and currently available techniques. Orthop Trauma. 2021;35(6):1877–1327. doi: 10.1016/j.mporth.2021.09.004
  9. Campbell RM Jr, Smith MD. Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am. 2007;89(Suppl 1):108–122. doi: 10.2106/JBJS.F.00270
  10. Mayer O, Campbell R, Cahill P, Redding G. Thoracic insufficiency syndrome. Curr Probl Pediatr Adolesc Health Care. 2016;46(3):72–97. doi: 10.1016/j.cppeds.2015.11.001
  11. Campbell RM Jr, Smith MD, Mayes TC, et al. The characteristics of thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am. 2003;85(3):399–408. doi: 10.2106/00004623-200303000-00001
  12. Romberg K, Fagevik Olsén M, Kjellby-Wendt G, Lofdahl Hallerman K, Danielsson A. Thoracic mobility and its relation to pulmonary function and rib-cage deformity in patients with early onset idiopathic scoliosis: a long-term follow-up. Spine Deform. 2020;8(2):257–268. doi: 10.1007/s43390-019-00018-y
  13. Farrell J, Garrido E. Predicting preoperative pulmonary function in patients with thoracic adolescent idiopathic scoliosis from spinal and thoracic radiographic parameters. Eur Spine J. 2021;30(3):634–644. doi: 10.1007/s00586-020-06552-y
  14. Hedequist DJ. Surgical treatment of congenital scoliosis. Orthop Clin North Am. 2007;38(4):497–509. doi: 10.1016/j.ocl.2007.05.002
  15. Campos MA, Weinstein SL. Pediatric scoliosis and kyphosis. Neurosurg Clin N Am. 2007;18(3):515–529. doi: 10.1016/j.nec.2007.04.007
  16. Davydova IV, Namazova-Baranova LS, Altunin VV, et al. Functional assessment of respiratoty disorders in children with bronchopulmonary dysplasia during follow-up. Pediatricheskaja farmakologija. 2014;11(6):42–51. (In Russ.). doi: 10.15690/pf.v11i6.1214
  17. Yashina LA, Polyanskaya MA, Zagrebel’nyy M.R. Impul’snaya ostsillometriya – novye vozmozhnosti v diagnostike i monitoringe obstruktivnykh zabolevaniy legkikh. Zdorov’ya Ukraїni. 2009;(23/1):26−27. (In Russ.)
  18. Cyplenkova SJe, Mizernickij JuL. Sovremennye vozmozhnosti funkcional’noi diagnostiki vneshnego dyhaniya u detei. Ros vestn perinatol i pediat. 2015;60(5):14−20. (In Russ.)
  19. Feldman DS, Schachter AK, Alfonso D, et al. Congenital scoliosis. Surg Manag Spinal Deformities. 2009:129–141. doi: 10.1016/B978-141603372-1.50012-3
  20. Quaye M, Harvey J. Introduction to spinal pathologies and clinical problems of the spine. Biomaterials for Spinal Surgery. 2012:78–113. doi: 10.1533/9780857096197.1.78
  21. Blevins K, Battenberg A, Beck A. Management of scoliosis. Advances in Pediatrics. 2018;65(1):249–266. doi: 10.1016/j.yapd.2018.04.013
  22. Desai U, Joshi JM. Impulse oscillometry. Adv Respir Med. 2019;87(4):235–238. doi: 10.5603/ARM.a2019.0039
  23. Savushkina OI, Chernyak AV, Kryukov EV, et al. Impul’snaya ostsillometriya v diagnostike narusheniy mekhaniki dykhaniya pri khronicheskoy obstruktivnoy bolezni legkikh. Pul’monologiya. 2020;30(3):285–294. (In Russ.). doi: 10.18093/0869-0189-2020-30-3-285-294
  24. Antonova E.A. Diagnostika narusheniy vneshnego dykhaniya u detey mladshego vozrasta (3–7 let), bol’nykh bronkhial’noy astmoy, po dannym impul’snoy ostsillometrii. Saint Petersburg; 2004. (In Russ.)
  25. Redding G, Song K, Inscore S, et al. Lung function asymmetry in children with congenital and infantile scoliosis. Spine J. 2008;8(4):639–644. doi: 10.1016/j.spinee.2007.04.020
  26. Flesch JD, Dine CJ. Lung volumes: measurement, clinical use, and coding. Chest. 2012;142(2):506–510. doi: 10.1378/chest.11-2964
  27. Caliskan E, Ozturk M. Determination of normal lung volume using computed tomography in children and adolescents. Original Article. 2019;26(4):588–592. doi: 10.5455/annalsmedres.2018.12.308
  28. Lattig F, Taurman R, Hell AK. Treatment of early-onset spinal deformity (EOSD) with VEPTR. Clinical Spine Surg. 2016;29(5):E246–E251. doi: 10.1097/BSD.0b013e31826eaf27
  29. Li C, Fu Q, Zhou Y, et al. Surgical treatment of severe congenital scoliosis with unilateral unsegmented bar by concave costovertebral joint release and both-ends wedge osteotomy via posterior approach. European Spine Journal. 2011;21(3):498–505. doi: 10.1007/s00586-011-1972-6
  30. Fender D, Purushothaman B. Spinal disorders in childhood II: spinal deformity. Surgery (Oxford). 2014;32(1):39–45. doi: 10.1016/j.mpsur.2013.11.001
  31. Campbell RM. Operative strategies for thoracic insufficiency syndrome by vertical expandable prosthetic titanium rib expansion thoracoplasty. Operative Techniques in Orthopaedics. 2005;15(4):315–325. doi: 10.1053/j.oto.2005.08.008
  32. Loughenbury PR, Gummerson NW, Tsirikos AI. Congenital spinal deformity: assessment, natural history and treatment. Orthop Trauma. 2017;31(6):364–369. doi: 10.1016/j.mporth.2017.09.007
  33. Kalidindi KKV, Sath S, Sharma J, Chhabra HS. Management of severe rigid scoliosis by total awake correction utilizing differential distraction and in situ stabilization. Interdisciplinary Neurosurgery. 2020;21:100778. doi: 10.1016/j.inat.2020.100778
  34. Campbell R, Hell-Vocke AK. The growth of the thoracic spine in congenital scoliosis after expansion thoracoplasty. Spine. 2002;2(5 Suppl):71–72. doi: 10.1016/S1529-9430(02)00317-0
  35. Skaggs, DL, Guillaume T, El-Hawary R, et al. (2015). Early onset scoliosis consensus statement, SRS Growing Spine Committee, 2015. Spine Deformity. 2015;3(2):107. doi: 10.1016/j.jspd.2015.01.002
  36. Lukina O.F. Osobennosti issledovaniya funktsii vneshnego dykhaniya u detey i podrostkov. Prakticheskaya pul’monologiya. 2017(4):39–44. (In Russ.)
  37. Lattig F, Taurman R, Hell AK. Treatment of early-onset spinal deformity (EOSD) with VEPTR. Clinical Spine Surgery. 2016;29(5):E246–E251. doi: 10.1097/BSD.0b013e31826eaf27
  38. Lonstein JE. Long-term outcome of early fusions for congenital scoliosis. Spine Deformity. 2018;6(5):552–559. doi: 10.1016/j.jspd.2018.02.003
  39. Murphy RF, Pacult MA, Barfield WR, et al. Experience with definitive instrumented final fusion after posterior-based distraction lengthening in patients with early-onset spinal deformity. J Pediatr Orthop B. 2019;28(1):10–16. doi: 10.1097/BPB.0000000000000559
  40. Johnston CE, Stephens Richards B, Sucato DJ, et al. Correlation of preoperative deformity magnitude and pulmonary function tests in adolescent idiopathic scoliosis. Spine. 2011;36:1096–1102. doi: 10.1097/BRS.0b013e3181f8c931
  41. Karol LA. The natural history of early-onset scoliosis. J Pediatr Orthop. 2019;39(6 Suppl 1):S38–S43. doi: 10.1097/BPO.0000000000001351
  42. Tomlinson JE, Gummerson NW. Paediatric spinal conditions. Surgery (Oxford). 2017;35(1):39–47. doi: 10.1016/j.mpsur.2016.10.013
  43. Gardner A. (i) Clinical assessment of scoliosis. Orthop Trauma. 2011;25(6):397–402. doi: 10.1016/j.mporth.2011.09.002
  44. Duenas-Meza E, Correa E, Lopez E, et al. Impulse oscillometry reference values and bronchodilator response in three-to five-year old children living at high altitude. J Asthma Allergy. 2019;12:263–271. doi: 10.2147/JAA.S214297

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2. Fig. 1. Patient S., 5 years old. Multislice computed tomography of the spine and chest organs in target structure modes. Multiplanar skew-coronal reconstruction (a) and volumetric images show projections of maximum intensity (b). Superficially shaded image — front view (c), posterior view (d) of segmentation disorders of the lateral surfaces of the vertebral bodies with subtotal left-sided costal synostosis (posterolateral sections); reconstruction of the chest organs with isolated visualization of bone tissue and lung parenchyma using tissue segmentation techniques (e)

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3. Fig. 2. Calculation of lung tissue volume in patient A., 5 years old, by constructing a virtual 3D model of the bronchopulmonary system based on inspiratory multispiral computed tomography data. Virtual model of the lungs: a — front view; b - side view; c - rear view

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4. Fig. 1. Patient S., 5 years old. Multispiral computed tomography of the spine and chest organs in target structure modes. Multiplanar skew coronal reconstruction (a) and volumetric images show projections of maximum intensity (b). Surface-shaded image, front view (c), posterior view (d) of segmentation disorders of the lateral surfaces of the vertebral bodies with subtotal left-sided costal synostosis (posterolateral sections); reconstruction of the chest organs with isolated visualization of the bone tissue and lung parenchyma using tissue segmentation techniques (e)

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5. Fig. 2. Calculation of the lung tissue volume in Patient A (5 years old) by constructing a virtual 3D model of the bronchopulmonary system based on inspiratory multispiral computed tomography findings. Virtual model of the lungs: a, front view; b, lateral view; c, posterior view

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Copyright (c) 2022 Vissarionov S.V., Asadulaev M.S., Orlova E.A., Toriya V.G., Kartavenko K.A., Rybinskikh T.S., Murashko T.V., Khardikov M.A., Kokushin D.N.

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