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Do Heavier Patients With Adolescent Idiopathic Scoliosis Have More Preserved Thoracic Kyphosis and Pulmonary Function?

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Abstract

Study Design

Retrospective.

Objectives

We aimed to determine if heavier patients with adolescent idiopathic scoliosis (AIS) had more preserved thoracic kyphosis (TK), and as a result, more preserved pulmonary function.

Summary of Background Data

Some believe that childhood weight is predictive of adult sagittal plane parameters, with heavier children having greater TK as adults. Generally, thoracic scoliosis is coupled with loss of TK, which is associated with worsening pulmonary function.

Methods

A total of 142 patients with AIS and a structural main thoracic curve were analyzed. We excluded patients with structural proximal thoracic curves (Lenke 2 and 4). Standing preoperative radiographs, pulmonary function tests, and preoperative body mass indices (BMIs) were reviewed. The main thoracic Cobb angle, T2–T12 TK, percentage predicted forced vital capacity (FVC) and BMI were recorded. Spearman correlation was determined. Linear regression analysis used FVC as the primary outcome and BMI, TK, and Cobb angle as the independent variables. BMI categories were overweight/obese (BMI ≥25) and normal (BMI <25). Wilcoxon rank-sum tests were performed to detect a difference in TK and BMI between the 2 groups. The Cobb angles between the two groups were analyzed by t tests.

Results

Demonstrated correlations included BMI and FVC (0.37, p ≤.01), FVC and TK (0.26, p <.01), BMI and TK (0.23, p = .01), and FVC and Cobb angle (–0.23, p = .01). Linear regression revealed that Cobb angle (p ≤.01), TK (p <.01), and BMI (p <.01) remained statistically significant predictors of FVC. Wilcoxon rank-sum tests revealed a statistically significant difference between TK (p = .03) and FVC (p <.01) in the overweight/obese group and the normal group, with the overweight/obese group having greater values for both TK and FVC. The Cobb angles between the overweight/obese and normal group were not significantly different (p = .72).

Conclusions

Heavier AIS patients have greater values of TK and percentage predicted FVC.

Level of Evidence

Level III.

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Author information

Authors and Affiliations

  1. University of Kansas School of Medicine, 3901 Rainbow Blvd, 66160, Kansas City, KS, USA

    Robert Tung BS & Mason Uvodich BS

  2. Children’s Mercy-Kansas City, 2401 Gillham Rd, 64108, Kansas City, MO, USA

    John T. Anderson MD, Katie Carpenter CPNP-PC & Ashley Sherman MA

  3. Department of Surgery, University of Nevada, Las Vegas, 4505 S. Maryland Pkwy, 89154, Las Vegas, NV, USA

    Rafael Lozano MD

Authors
  1. Robert Tung BS
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  2. Mason Uvodich BS
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  3. John T. Anderson MD
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  4. Katie Carpenter CPNP-PC
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  5. Ashley Sherman MA
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  6. Rafael Lozano MD
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Corresponding author

Correspondence to John T. Anderson MD.

Additional information

Author disclosures: RT (none), MU (none), JTA (paid speaker at an American Academy of Pediatrics CME course), KC (none), AS (none), RL (none).

Reviewed and approved by the Pediatric IRB at The Children’s Mercy Hospital & Clinics (IRB No. 16010073).

No funding was received for the purpose of this study.

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Tung, R., Uvodich, M., Anderson, J.T. et al. Do Heavier Patients With Adolescent Idiopathic Scoliosis Have More Preserved Thoracic Kyphosis and Pulmonary Function?. Spine Deform 6, 704–706 (2018). https://doi.org/10.1016/j.jspd.2018.05.007

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  • DOI: https://doi.org/10.1016/j.jspd.2018.05.007

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