RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Study Design: Cross-sectional study.Purpose: To evaluate sagittal balance, pulmonary function, and spinopelvic parameters in patients with healed spinal tuberculosis with severe thoracic kyphosis.Overview of Literature: Deterioration of neurological function is an absolute indication of surgical intervention in severe post-tubercular kyphosis, but the relationship of compromise in lung function and spinal alignment with severity of kyphosis is still unclear.Methods: Twenty patients (age, 14–60 years) with healed spinal tuberculosis with thoracic kyphosis >50° were included. Lateral-view radiography of the whole spine, including both hips, was performed for assessment of kyphotic angle (K angle), sagittal balance, lumbar lordosis, and spinopelvic parameters. Pulmonary function was assessed by measuring the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and their ratio (FEV1/FVC) by spirometry.Results: A positive correlation between severity of kyphosis and sagittal imbalance was noted, with compensatory mechanisms maintaining the sagittal balance in only up to 80° of dorsal kyphosis. In >80° of kyphosis, FVC was found to be markedly decreased (mean FVC=50.6%). The mean K angle was lower in subjects with lower thoracic kyphosis. In lower thoracic kyphosis, due to short lordotic and long kyphotic curves, both lumbar lordosis and pelvic retroversion worked at compensation, whereas, in middle thoracic kyphosis, due to long lordotic curve, only lumbar lordosis was required. Normal pulmonary function (mean FVC, 83.0%) and lesser kyphotic deformity (mean K angle in adolescents, 69.8°; in adults, 94.4°) were found in adolescents.Conclusions: In >80° of thoracic kyphosis, there is sagittal imbalance and a markedly affected pulmonary function. Such patients should be offered corrective surgery if they are symptomatic and medically fit to undergo the procedure. However, whether the surgical procedure would result in improved pulmonary function and sagittal balance needs to be evaluated by a follow-up study.

참고문헌 (Reference)

1 Zeng Y, "The influence of kyphosis correction surgery on pulmonary function and thoracic volume" 39 : 1777-1784, 2014

2 Cheung JPY, "The importance of sagittal balance in adult scoliosis surgery" 8 : 35-, 2020

3 Celestre PC, "Spinopelvic parameters : lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope : what does a spine surgeon need to know to plan a lumbar deformity correction?" 29 : 323-329, 2018

4 Garg RK, "Spinal tuberculosis : a review" 34 : 440-454, 2011

5 Tuli SM, "Severe kyphotic deformity in tuberculosis of the spine" 19 : 327-331, 1995

6 Roussouly P, "Sagittal plane deformity : an overview of interpretation and management" 19 : 1824-1836, 2010

7 Mac-Thiong JM, "Sagittal parameters of global spinal balance : normative values from a prospective cohort of seven hundred nine Caucasian asymptomatic adults" 35 : E1193-8, 2010

8 Boulay C, "Sagittal alignment of spine and pelvis regulated by pelvic incidence : standard values and prediction of lordosis" 15 : 415-422, 2006

9 Kanathur N, "Pulmonary manifestations of ankylosing spondylitis" 31 : 547-554, 2010

10 Sampaio-Barros PD, "Pulmonary involvement in ankylosing spondylitis" 26 : 225-230, 2007