Biplanar stereoradiography predicts pulmonary function tests in adolescent idiopathic scoliosis: a cross-sectional study

  • H. BouloussaEmail author
  • R. Pietton
  • C. Vergari
  • T. X. Haen
  • W. Skalli
  • R. Vialle
Original Article



Various spinal and rib cage parameters measured from complex examinations were found to be correlated with preoperative pulmonary function tests (PFT). The aim was to investigate the relationship between preoperative rib cage parameters and PFT using biplanar stereoradiography in patients with severe adolescent idiopathic scoliosis.


Fifty-four patients, 45 girls and nine boys, aged 13.8 ± 1.2 years, with Lenke 1 or 2 thoracic scoliosis (> 50°) requiring surgical correction were prospectively included. All patients underwent preoperative PFT and low-dose biplanar X-rays. The following data were collected: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, residual volume, slow vital capacity (SVC), total lung capacity (TLC), rib cage volume (RCV), maximum rib hump, maximum width, mean thoracic index, spinal penetration index, apical vertebral rotation, main curve Cobb angle (MCCA), T4–T12 kyphosis. The primary outcome was the relationship between rib cage parameters and PFT. The secondary outcome was the relationship between rib cage parameters and spine parameters. Data were analyzed using Spearman’s rank test. A multivariable regression analysis was performed to compare PFTs and structural parameters. Significance was set at α = 0.05.


The mean MCCA was 68.7° ± 16.7°. RCV was highly correlated with all pulmonary capacities: TLC (r = 0.76, p < 0.0001), SVC (r = 0.78, p < 0.0001) and FVC (r = 0.77, p < 0.0001). RCV had a low correlation with FEV1/FVC (r = − 0.34, p = 0.014). SPI was not correlated with any pulmonary parameters.


Rib cage volume measured by biplanar stereoradiography may represent a prediction tool for PFTs.

Level of evidence

Non-randomized cross-sectional study among consecutive patients, Level 2.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Pulmonary function tests AIS Three-dimensional reconstructions Rib cage Scoliosis 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

586_2019_5940_MOESM1_ESM.pptx (785 kb)
Supplementary material 1 (PPTX 786 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pediatric Orthopedics, Armand Trousseau HospitalParis 6 UniversityParisFrance
  2. 2.Arts et Métiers ParisTech, LBM/Institut de Biomécanique Humaine Georges CharpakParisFrance
  3. 3.Department of Spine SurgeryKaiser Permanente Oakland Medical CenterOaklandUSA

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