Glotzbecker Michael, Johnston Charles, Miller Patricia, Smith John, Perez-Grueso Francisco Sanchez, Woon Regina, Flynn John, Gold Meryl, Garg Sumeet, Redding Gregory, Cahill Patrick, Emans John
*Department of Orthopaedic Surgery, Children's Hospital, Boston, MA †Texas Scottish Rite Hospital for Children, Dallas, TX ‡Primary Children's Medical Center, Salt Lake City, UT §Hospital Universitario La Paz, Madrid, Spain ¶Children's Hospital Los Angeles, Los Angeles, CA ‖Children's Hospital of Philadelphia, Philadelphia, PA **Children's Hospital Colorado, Denver, CO ††Seattle Children's Hospital, Seattle, WA, and ‡‡Shriners Hospital for Children, Philadelphia, PA.
Spine (Phila Pa 1976). 2014 Sep 1;39(19):1590-5. doi: 10.1097/BRS.0000000000000449.
Cross-sectional retrospective analysis.
To examine the degree of correlation between thoracic dimension outcome measures and pulmonary function in early-onset scoliosis (EOS).
Change in thoracic dimension (TD) measurements and spine length are commonly reported outcome measures after treatment for EOS. Although ultimately improving or maintaining pulmonary function is the goal of EOS treatment strategies, it is unclear whether commonly reported 2-dimensional TD measurements represent good predictors of pulmonary function.
A cross-sectional analysis of patients including all diagnoses obtained from 2 EOS databases containing TD measurements and pulmonary function data was performed. Relationships between individual TD measurements and pulmonary function measurements were assessed using the Pearson correlation analysis. TD measurements (pelvic inlet width, T1-T12 height, T1-S1 height, and coronal chest width) and standard pulmonary function measurements were compared. TD percentiles normalized for pelvic inlet width were also calculated and correlated with pulmonary function measurement percentiles. Univariate and multivariate linear regression analyses determined whether TD measurements could predict pulmonary function.
There were 121 patients (65 females, 56 males) in the study. Mean age at evaluation was 9.3 years (range, 2.7-18.1 yr). T1-T12 height, T1-S1 height, maximal chest width, and pelvic inlet width were all significantly correlated with forced air volume expelled in 1 second, total forced air volume, and total lung capacity (correlation coefficients [r] 0.33-0.61; all P<0.001). T1-T12 predicted percentile (normalized for pelvic width) was significantly correlated with forced air volume expelled in 1 second and total forced air volume predicted percentiles (r=0.32, P<0.001 and r=0.27, P=0.004, respectively). Regression analysis determined that T1-T12 percentile was a significant predictor of forced air volume expelled in 1 second percentile and total forced air volume percentiles. Regression analysis found no predictive factors of total lung capacity percentile.
Traditional 2-dimensional TD measurements (T1-T12 height) used to measure outcomes in EOS can be used as weak predictors of pulmonary function outcome. However, better outcome measures need to be developed, such as 3-dimensional and dynamic measurements.
横断面回顾性分析。
研究早发性脊柱侧弯（EOS）患者胸廓尺寸测量结果与肺功能之间的相关程度。
胸廓尺寸（TD）测量值和脊柱长度的变化是EOS治疗后常用的报告结局指标。尽管最终改善或维持肺功能是EOS治疗策略的目标，但尚不清楚常用的二维TD测量值是否能很好地预测肺功能。
对来自两个包含TD测量值和肺功能数据的EOS数据库中的所有诊断患者进行横断面分析。使用Pearson相关分析评估各个TD测量值与肺功能测量值之间的关系。比较TD测量值（骨盆入口宽度、T1-T12高度、T1-S1高度和冠状胸廓宽度）和标准肺功能测量值。还计算了针对骨盆入口宽度标准化的TD百分位数，并将其与肺功能测量百分位数进行关联。单因素和多因素线性回归分析确定TD测量值是否可以预测肺功能。
本研究共纳入121例患者（65例女性，56例男性）。评估时的平均年龄为9.3岁（范围2.7-18.1岁）。T1-T12高度、T1-S1高度、最大胸廓宽度和骨盆入口宽度均与第1秒用力呼气量、用力肺活量和肺总量显著相关（相关系数[r]为0.33-0.61；均P<0.001）。T1-T12预测百分位数（针对骨盆宽度标准化）与第1秒用力呼气量预测百分位数和用力肺活量预测百分位数显著相关（分别为r=0.32，P<0.001和r=0.27，P=0.004）。回归分析确定T1-T12百分位数是第1秒用力呼气量百分位数和用力肺活量百分位数的重要预测指标。回归分析未发现肺总量百分位数的预测因素。
用于测量EOS结局的传统二维TD测量值（T1-T12高度）可作为肺功能结局的弱预测指标。然而，需要开发更好的结局指标，如三维和动态测量指标。
3级。
Zotero 插件