Radionuclide Evaluation of Pulmonary Perfusion in Patients with Severe Thoracic Scoliosis Before and After Surgery
- Authors: Karalkin A.V1, Lisyanskiy I.N1, Kuleshov A.A1, Vetrile M.S1
-
Affiliations:
- Issue: Vol 20, No 3 (2013)
- Pages: 3-10
- Section: Articles
- Submitted: 20.10.2020
- Published: 15.09.2013
- URL: https://journals.eco-vector.com/0869-8678/article/view/47652
- DOI: https://doi.org/10.17816/vto20132033-10
- ID: 47652
Cite item
Full Text
Abstract
The purpose of the study was to evaluate the influence of severe scoliosis surgical correction upon pulmonary microcirculation. The study included 8 patients aged 12— 27 years with severe thoracic scoliosis. Angle deformity by Cobb ranged from 80 to 140° (mean 120.4°). Deformity correction and fixation was performed on the concave side of thorax using multilevel CotrelDubousset instrumentation (CDI) and elevating thoracoplasty (ET). Perfusion radionuclide pulmonary scintigraphy was performed prior to, 3 months and 1 year after surgery. Analysis of pulmonary scintigrams included both the qualitative (visual) and quantitative assessments. Besides, examination of external respiration function (spirometry and spirography) was performed. Mean postoperative Cobb angle made up 67.4°. No loss of correction was noted. Prior to surgical intervention pulmonary scintigrams showed deformation of lung fields, displacement along the vertical axis towards opposite to curvature side, decreased perfusion in the zone of intercostal retraction on the concave side of thorax. Postoperatively restoration of vertical axis, increase of lungs size and improvement of perfusion were observed. Mean vital lung capacity increased from 1510 (540-2280) to 2090 (640-3010) ml. Thus, combined application of CDI and ET enabled to perform adequate correction of severe thoracic scoliosis as well as to improve pulmonary microcirculation and radionuclide perfusion scintigraphy was a highly informative method for the evaluation of lung condition.
Full Text
Радионуклидная оценка перфузии легких у больных тяжелым сколиозом×
About the authors
AV. V Karalkin
I. N Lisyanskiy
Email: cito-spine@mail.ru
A. A Kuleshov
M. S Vetrile
References
- Михайловский М.В., ред. Хирургия идиопатического сколиоза: ближайшие и отдаленные результаты. Новосибирск: АНО «Клиника НИИТО»; 2OO7: 235-5б.
- Day G.A. Pulmonary functions in congenital scoliosis. Spine. 1QQ4; 1Q (Q): 1O27—31.
- Ebenbicher G. Scoliosis and its conservative treatment possibilities. Wein. Med. Wschr. 1QQ4; 144 (24): 5Q3-6O4.
- Meurer A., Hopf C., Heine J. Natural course with idiopathic scoliosis. Orthopade. 1QQ4; 23 (3): 228-35.
- Steinberg J. Cor pulmonale kyphoscoliosis. Am. J. Roentgenol. 1Q66; 3: б58-б3.
- Swank S.M., Winter R.B., Moe J.H. Scoliosis and cor pulmonary. Spine. 1Q82; 7 (4): 343-54.
- Кулешов А.А., Ветрилэ С.Т., Лисянский И.Н., Ветрилэ М.С., Захарин Р.Г., Гусейнов В.Г. Комплексное оперативное лечение тяжелых сколиозов с применением элевационной торакопластики. Хирургия позвоночника. 2O12; 2: 37-43.
- Михайловский М.В., Лебедева М.Н., Садовая Т.Н., Губина Е.В., Сарнадский В.Н. Ближайшие и отдаленные результаты хирургического лечения пациентов со сверхтяжелыми формами идиопатического сколиоза. Хирургия позвоночника. 2OOQ; 2: 38-47.
- Q. Barwick T.D., Goddard I., Easty M., Wallis C., Biassoni L. Postural change in ventilation and perfusion secondary to a thoracic scoliosis with complete resolution after surgery. Br. J. Radiol. 2009; 82 (979): e137-40.
- Неманова Д.И. Состояние кардиореспираторной системы у подростков с различной степенью сколиоза. Дис.. канд. мед. наук. М.; 2003: 55-62.
- Zhang H.Q., Wang Y.X., Guo C.F., Tang M.X., Chen L.Q., Liu S.H., Wang Y.F., Chen J. Posterior-only surgery with strong halo-femoral traction for the treatment of adolescent idiopathic scolotic curves more then 100°. Int. Ortop. 2011; 35 (7): 1037-42.
- Зильбер А.П. Регионарные функции легких. Клиническая физиология неравномерности вентиляции и кровотока. Петрозаводск: Карелия; 1971.
- Дмитриева Л.И., Шмелев Е.И., Степанян И.Э., Сигаев А.Т. Принцип лучевой диагностики интерстициальных заболеваний легких. Пульмонология. 1999; 4: 11-7.
- Кулешов А.А., Ветрилэ С.Т., Швец В.В, Ветрилэ М.С., Захарин Р.Г., Лисянский И.Н. Способ хирургической коррекции вогнутой деформации грудной клетки у больных с тяжелым сколиозом. Патент на изобретение №2449734; 10.05.2012.
- Савельев В.С., Яблоков Е.Г., Кириенко А.И. Тромбоэмболия легочных артерий. М.: Медицина; 1979: 190-5.
- Chilton H.M., Ball J.D. Radiopharmaceuticals for lungs imaging. In: Swanson D.P., Chilton A.M., Thrall J.H., eds. Pharmaceuticals in medical imaging. N.Y.: MacMillan Publ.; 1990: 394-415.
- Redding G, Song K, Inscore S., Effmann E., Campbell R. Lung function asymmetry in children with congenital and infantile scoliosis. Spine J. 2008; 8 (4): 639-44.
- Redding G.J., Mayer O.H. Structure-respiration function relationships before and after surgical treatment of early-onsetscoliosis. Clin. Orthop. Relat. Res. 2011; 469 (5): 1330-4.
- Giordano A., Fuso L., Galli M., Calcagni M.L., Aulisa L, Pagliari G., Pistelli R. Evaluation of pulmonary ventilation and diaphragmatic movement in idiopathic scoliosis using radioaerosol ventilation scintigraphy. Nucl. Med. Commun. 1997; 18: 105-11.
- Littler W.A., Brown I.K., Roaf R. Regional lung function in scoliosis. Thorax. 1972; 27: 420-8.
- Shannon D.C., Riseborough E.J., Valenca L.M., Kazemi H. The distribution of abnormal lung function in kyphoscoliosis. J. Bone Joint Surg. Am. 1970; 52: 131-44.
- Grau M., Leisner B., Rohloff R., Fink U., Moser E., Matzen K.A., Hüusinger K. Functional scintigraphy of pulmonary ventilation with 133Xe in juvenile scoliosis (author’s transl). Nuklearmedizin. 1981; 20: 178-82.