Radionuclide Evaluation of Pulmonary Perfusion in Patients with Severe Thoracic Scoliosis Before and After Surgery

Abstract

The purpose of the study was to evaluate the influence of severe scoliosis surgical correction upon pulmonary microcirculation. The study included 8 patients aged 12— 27 years with severe thoracic scoliosis. Angle deformity by Cobb ranged from 80 to 140° (mean 120.4°). Deformity correction and fixation was performed on the concave side of thorax using multilevel CotrelDubousset instrumentation (CDI) and elevating thoracoplasty (ET). Perfusion radionuclide pulmonary scintigraphy was performed prior to, 3 months and 1 year after surgery. Analysis of pulmonary scintigrams included both the qualitative (visual) and quantitative assessments. Besides, examination of external respiration function (spirometry and spirography) was performed. Mean postoperative Cobb angle made up 67.4°. No loss of correction was noted. Prior to surgical intervention pulmonary scintigrams showed deformation of lung fields, displacement along the vertical axis towards opposite to curvature side, decreased perfusion in the zone of intercostal retraction on the concave side of thorax. Postoperatively restoration of vertical axis, increase of lungs size and improvement of perfusion were observed. Mean vital lung capacity increased from 1510 (540-2280) to 2090 (640-3010) ml. Thus, combined application of CDI and ET enabled to perform adequate correction of severe thoracic scoliosis as well as to improve pulmonary microcirculation and radionuclide perfusion scintigraphy was a highly informative method for the evaluation of lung condition.