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. 2023 Apr 24;13(1):6634.
doi: 10.1038/s41598-023-33445-z.

Abolition of sagittal T7-T10 dynamics during forced ventilation in AIS patients with Lenke 1A curves

Gonzalo Mariscal  1 , Jesús Burgos  2 , Luis Antón-Rodrigálvarez  3 , Eduardo Hevia  4 , Carlos Barrios  5
Affiliations

Abolition of sagittal T7-T10 dynamics during forced ventilation in AIS patients with Lenke 1A curves

Gonzalo Mariscal et al. Sci Rep. .

Abstract

In healthy subjects, respiratory maximal volumes are highly dependent on the sagittal range of motion of the T7-T10 segment. In AIS, the abolition of T7-T10 dynamics related to the stiffness induced by the apex region in Lenke IA curves could harm ventilation during maximal breathing. The aim of this study was to analyze the dynamics of the thoracic spine during deep breathing in AIS patients and in healthy matched controls. This is a cross-sectional, case-control study. 20 AIS patients (18 girls, Cobb angle, 54.7 ± 7.9°; Risser 1.35 ± 1.2) and 15 healthy volunteers (11 girls) matched in age (12.5 versus 15.8 years mean age) were included. In AIS curves, the apex was located at T8 (14) and T9 (6). Conventional sagittal radiographs of the whole spine were performed at maximal inspiration and exhalation. The ROM of each spinal thoracic functional segment (T1-T7, T7-T10, T10-T12) and the global T1-T12 ROM were measured. In healthy subjects, the mean T1-T12 ROM during forced breathing was 16.7 ± 3.8. AIS patients showed a T1-T12 ROM of 1.1 ± 1.5 (p < 0.05), indicating a sagittal stiffness of the thoracic spine. A wide T7-T10 ROM (15.3 ± 3.0) was found in healthy controls (91.6% of the T1-T12 ROM). AIS patients showed only 0.4 ± 1.4 ROM at T7-T10 (36.4% of the T1-T12 ROM) (p < 0.001). There was a linear relationship between the magnitude of T7-T10 kyphosis in maximal exhalation and both FVC (% of predicted FVC) and FEV1. In conclusion, Lenke 1A AIS patients show a restriction of the thoracic spine motion with an almost complete abolition of T7-T10 ROM, a crucial segment for deep breathing. T7-T10 stiffness could explain the ventilatory limitations found in AIS patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Raincloud plots with horizontal display showing data from the global T1–T12 kyphosis range of motion in the two phases of forced breathing.
Figure 2
Figure 2
Mean differences in the sagittal range of motion from maximal inspiration to maximal exhalation.
Figure 3
Figure 3
Raincloud plots with horizontal display showing data from the T7–T10 kyphosis range of motion in the two phases of forced breathing.
Figure 4
Figure 4
Correlation plots showing the positive interdependence between the magnitude of T7–T10 kyphosis in maximal exhalation and both forced vital capacity (% of precited FVC) and FEV1.
See this image and copyright information in PMC

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