Paper #21: Serial Measures of Lung and Inspiratory Muscle Function in Children With Early-Onset Scoliosis

Abstract

change in diaphragm volume less than convex, 1 had concave greater than convex, and 2 had equal volumes. For 3 patients with postoperative scans, concave change in rib cage volume increased 57% (convex, 72%) and change in diaphragm volume increased 128% (convex, 109%). Concave kidney excursion increased 6.3 mm (320%), and convex 5.2 mm (192%). Complications included 2 patients with migration of devices proximally. Conclusions: Quantitative dMRI can measure separate contributions of diaphragm and rib cage to lung expansion during respiration for each hemithorax, enabling accurate assessment of thoracic function for the first time. Vertical Expandable Prosthetic Titanium Rib treatment appears to increase rib cage expansion more on the convex side of the thorax than the concave, and conversely increases diaphragm excursion on the concave side. With treatment, renal excursion increases bilaterally, concave more than convex, probably reducing a blockade effect on the diaphragm. Quantitative dMRI has the potential to increase understanding of the anatomic mechanisms of spine/chest wall deformity that cause restrictive lung disease in NM scoliosis, and may enable the development of new treatments for it.