{"title":"Scoliosis progression after lung transplantation","authors":"Takayoshi Shimizu MD, PhD , Satona Tanaka MD, PhD , Bungo Otsuki MD, PhD , Koki Kawasaki MD , Takashi Sono MD, PhD , Koichi Murata MD, PhD , Daisuke Nakajima MD, PhD , Shuichi Matsuda MD, PhD , Hiroshi Date MD, PhD","doi":"10.1016/j.spinee.2024.12.030","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>Scoliosis is a potential postoperative complication of various pediatric cardiothoracic conditions.</div></div><div><h3>PURPOSE</h3><div>To investigate the incidence of scoliosis in pediatric lung transplant patients and explore the factors associated with its development.</div></div><div><h3>STUDY DESIGN</h3><div>Retrospective observational study.</div></div><div><h3>PATIENT SAMPLE</h3><div>About 330 consecutive lung transplant recipients at a single institution between April 2002 and June 2022.</div></div><div><h3>OUTCOME MEASURES</h3><div>The incidence of scoliosis.</div></div><div><h3>METHODS</h3><div>After excluding 45 patients with <1 year of follow-up, 285 patients were analyzed: 43 pediatric (≤17 years) and 242 adult (>18 years) patients. Data on baseline demographics, Cobb angle measurements pre- and posttransplant, and lung volumes at 1-year posttransplant in pediatric patients were collected. The prevalence of scoliosis was compared between pediatric and adult patients. Additionally, the impact of lung volume differences (right minus left) on scoliosis progression was assessed.</div></div><div><h3>RESULTS</h3><div>Pediatric (<em>n</em>=43) and adult (<em>n</em>=242) patients had a mean age of 10.3 and 44.9 years, respectively. Scoliosis was significantly more prevalent in pediatric patients, with 30.2% having a Cobb angle >10° and 13.9% having a Cobb angle >20°, compared to 11.5% and 1.6% in adults, respectively. Pediatric patients with Cobb angles >20° exhibited significant lung volume differences 1-year posttransplant. Lung volume disparities increased the risk of scoliosis progression, particularly in patients with unilateral lung collapse.</div></div><div><h3>CONCLUSIONS</h3><div>Pediatric lung transplant recipients have a higher incidence of significant scoliosis than adult recipients. Posttransplant lung volume disparities, especially in cases of unilateral lung collapse, may contribute to scoliosis progression. Routine spinal assessments are necessary for managing scoliosis in pediatric lung transplant patients to prevent curvature progression and ensure long-term musculoskeletal health.</div></div>","PeriodicalId":49484,"journal":{"name":"Spine Journal","volume":"25 6","pages":"Pages 1255-1262"},"PeriodicalIF":4.7000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1529943025000130","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
BACKGROUND CONTEXT
Scoliosis is a potential postoperative complication of various pediatric cardiothoracic conditions.
PURPOSE
To investigate the incidence of scoliosis in pediatric lung transplant patients and explore the factors associated with its development.
STUDY DESIGN
Retrospective observational study.
PATIENT SAMPLE
About 330 consecutive lung transplant recipients at a single institution between April 2002 and June 2022.
OUTCOME MEASURES
The incidence of scoliosis.
METHODS
After excluding 45 patients with <1 year of follow-up, 285 patients were analyzed: 43 pediatric (≤17 years) and 242 adult (>18 years) patients. Data on baseline demographics, Cobb angle measurements pre- and posttransplant, and lung volumes at 1-year posttransplant in pediatric patients were collected. The prevalence of scoliosis was compared between pediatric and adult patients. Additionally, the impact of lung volume differences (right minus left) on scoliosis progression was assessed.
RESULTS
Pediatric (n=43) and adult (n=242) patients had a mean age of 10.3 and 44.9 years, respectively. Scoliosis was significantly more prevalent in pediatric patients, with 30.2% having a Cobb angle >10° and 13.9% having a Cobb angle >20°, compared to 11.5% and 1.6% in adults, respectively. Pediatric patients with Cobb angles >20° exhibited significant lung volume differences 1-year posttransplant. Lung volume disparities increased the risk of scoliosis progression, particularly in patients with unilateral lung collapse.
CONCLUSIONS
Pediatric lung transplant recipients have a higher incidence of significant scoliosis than adult recipients. Posttransplant lung volume disparities, especially in cases of unilateral lung collapse, may contribute to scoliosis progression. Routine spinal assessments are necessary for managing scoliosis in pediatric lung transplant patients to prevent curvature progression and ensure long-term musculoskeletal health.
期刊介绍：
The Spine Journal, the official journal of the North American Spine Society, is an international and multidisciplinary journal that publishes original, peer-reviewed articles on research and treatment related to the spine and spine care, including basic science and clinical investigations. It is a condition of publication that manuscripts submitted to The Spine Journal have not been published, and will not be simultaneously submitted or published elsewhere. The Spine Journal also publishes major reviews of specific topics by acknowledged authorities, technical notes, teaching editorials, and other special features, Letters to the Editor-in-Chief are encouraged.
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