Pediatric Traumatology, Orthopaedics and Reconstructive SurgeryPediatric Traumatology, Orthopaedics and Reconstructive SurgeryОртопедия, травматология и восстановительная хирургия детского возрастаPediatric Traumatology, Orthopaedics and Reconstructive Surgery2309-39942410-8731Eco-Vector8997810.17816/PTORS89978Clinical studiesКлинические исследованияClinical studiesResearch ArticleAssessment of the respiratory system in children with congenital scoliosis by impulse oscillometry and computed tomography (preliminary results)Оценка состояния респираторной системы у детей с врожденным сколиозом методом импульсной осциллометрии и компьютерной томографии (предварительные результаты)脉冲振荡测量法和计算机断层扫描对先天性脊柱侧凸患儿呼吸系统的评估（初步结果）https://orcid.org/0000-0003-4235-50486504128319P-8596-20157125-4930VissarionovSergei V.ВиссарионовСергей ВалентиновичVissarionovSergei V.
Russian Federation

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

д-р мед. наук, профессор, чл.-корр. РАН

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

vissarionovs@gmail.comhttps://orcid.org/0000-0002-1768-2402571916187433336-8996AsadulaevMarat S.АсадулаевМарат СергеевичAsadulaevMarat S.
Russian Federation

MD, PhD student

Аспирант

MD, PhD student

marat.asadulaev@yandex.ruhttps://orcid.org/0000-0002-3128-980XOrlovaElena A.ОрловаЕлена АнтоновнаOrlovaElena A.
Russian Federation

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

канд. мед. наук, врач функциональной диагностики

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

eaorlova65@mail.ruhttps://orcid.org/0000-0002-2056-97261797-5031ToriyaVachtang G.ТорияВахтанг ГамлетовичToriyaVachtang G.
Russian Federation

MD, neurosurgeon

врач-нейрохирург

MD, neurosurgeon

vakdiss@yandex.ruhttps://orcid.org/0000-0002-6112-3309571932720635341-4492KartavenkoKirill A.КартавенкоКирилл АлександровичKartavenkoKirill A.
Russian Federation

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

канд. мед. наук

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

med-kart@yandex.ruhttps://orcid.org/0000-0002-4180-53537739-4321RybinskikhTimofey S.РыбинскихТимофей СергеевичRybinskikhTimofey S.
Russian Federation

6th year student

студент 6-го курса

6th year student

timofey1999r@gmail.comhttps://orcid.org/0000-0002-0596-37419295-6453MurashkoTatyana V.МурашкоТатьяна ВалерьевнаMurashkoTatyana V.
Russian Federation

MD, radiologist

врач-рентгенолог

MD, radiologist

popova332@mail.ruhttps://orcid.org/0000-0002-8269-0900572030146833378-7685KhardikovMikhail A.ХардиковМихаил АлександровичKhardikovMikhail A.
Russian Federation

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

канд. мед. наук

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

denica1990@bk.ruhttps://orcid.org/0000-0002-2510-7213571932577689071-4853KokushinDmitry N.КокушинДмитрий НиколаевичKokushinDmitry N.
Russian Federation

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

канд. мед. наук

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

partgerm@yandex.ruH. Turner National Medical Research Center for Children’s Orthopedics and Trauma SurgeryНациональный медицинский исследовательский центр детской травматологии и ортопедии им. Г.И. ТурнераH. Turner National Medical Research Center for Children’s Orthopedics and Trauma SurgeryChildren’s municipal multi-specialty clinical center of high medical technology named after K.A. RauhfusДетский городской многопрофильный клинический центр высоких медицинских технологий им. К.А. РаухфусаChildren’s municipal multi-specialty clinical center of high medical technology named after K.A. RauhfusH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma SurgeryНациональный медицинский исследовательский центр детской травматологии и ортопедии им. Г.И. ТурнераH. Turner National Medical Research Center for Сhildren’s Orthopedics and Trauma Surgery280220222403202210133421912202128022022Copyright ©; 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.Copyright ©; 2022, Виссарионов С.В., Асадулаев М.С., Орлова Е.А., Тория В.Г., Картавенко К.А., Рыбинских Т.С., Мурашко Т.В., Хардиков М.А., Кокушин Д.Н.Copyright ©; 2022, Vissarionov S., Asadulaev M., Orlova E., Toriya V., Kartavenko K., Rybinskikh T., Murashko T., Khardikov M., Kokushin D.2022Vissarionov 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.Виссарионов С.В., Асадулаев М.С., Орлова Е.А., Тория В.Г., Картавенко К.А., Рыбинских Т.С., Мурашко Т.В., Хардиков М.А., Кокушин Д.Н.Vissarionov S., Asadulaev M., Orlova E., Toriya V., Kartavenko K., Rybinskikh T., Murashko T., Khardikov M., Kokushin D.https://creativecommons.org/licenses/by-nc-nd/4.0/https://journals.eco-vector.com/turner/article/view/89978

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.

Обоснование. Нарушение сегментации боковых поверхностей тел позвонков и реберный синостоз — один из самых тяжелых вариантов врожденной патологии позвоночника и грудной клетки, которые приводят к развитию синдрома торакальной недостаточности, проявляющегося в неспособности грудной клетки обеспечивать нормальную дыхательную механику.

Цель — представить предварительные результаты функциональных и лучевых (КТ-морфометрических) исследований легких у пациентов с врожденным сколиозом грудного отдела позвоночника при нарушении сегментации боковых отделов тел позвонков и одностороннем синостозе ребер.

Материалы и методы. Дизайн исследования — малая клиническая серия. В проспективное исследование включены данные импульсной осциллометрии и КТ-морфометрии при 3D-реконструкции данных мультиспиральной компьютерной томографии органов грудной клетки 10 пациентов в возрасте от 3 до 7 лет с врожденным сколиозом грудного отдела позвоночника при одностороннем нарушении сегментации боковых поверхностей тел позвонков и одностороннем синостозе ребер.

Результаты. При исследовании дыхательной функции с применением импульсной осциллометрии в 7 клинических случаях не выявлено дыхательных нарушений. У 3 детей с вентиляционными нарушениями по данным импульсной осциллометрии наиболее значимые изменения касались параметров общего дыхательного импеданса, а также резонансной частоты и частотной зависимости резистивного компонента. У всех пациентов морфометрические показатели оценки легких, выявленные по 3D-модели легкого, соответствовали результатам исследования легочной функции методом импульсной осциллометрии.

Заключение. Дальнейшее изучение проблемы оценки функции дыхания у детей с врожденным сколиозом представляется перспективным как в диагностическом плане, так и для определения эффективности хирургического лечения.

论证。椎体侧表面分割异常和肋骨融合是脊柱和胸部先天性病理中最严重的变异之一，导致胸廓功能不全综合征的发展，表现为胸部无法提供正常的呼吸力学。

本研究的目的介绍先天性胸椎侧凸伴椎体侧表面分割异常和单侧肋骨融合患者的肺功能和X线（CT形态测量）研究的初步结果。

材料与方法。研究设计是一个小的临床系列。该前瞻性研究包括脉冲振荡仪和CT形态测量数据，并对10名3至7岁的胸椎先天性脊柱侧弯并伴有单侧椎体侧表面分割异常和单侧肋骨融合的患者进行多螺旋计算机断层扫描数据的三维重建。

结果。在脉搏振荡测量呼吸功能的研究中，7例临床病例未发现呼吸功能障碍。在3例通气障碍患儿中，根据脉搏振荡测定，最显著的变化是总呼吸阻抗参数，以及谐振频率和电阻分量的频率依赖性。在所有患者中，三维肺模型识别的形态测量肺评估指标与脉冲振荡测量肺功能的研究结果相一致。

结论。对先天性脊柱侧凸患儿呼吸功能评估问题的进一步研究在诊断和确定手术治疗的有效性方面似乎都有希望。

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