Tsuchiya N, Yogi S, Yogi A, Iida G, Yonemoto K, Shimabukuro T, Nishida K, Nishie A. Computed tomography-derived assessment of respiratory impairment in thoracic scoliosis: Comparison between idiopathic and non-idiopathic etiologies. World J Radiol 2026; 18(6): 119975 [DOI: 10.4329/wjr.119975]
Corresponding Author of This Article
Nanae Tsuchiya, MD, PhD, Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Kiyuna 1076, Ginowan 9012720, Okinawa, Japan. nanaeasygoing@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Tsuchiya N, Yogi S, Yogi A, Iida G, Yonemoto K, Shimabukuro T, Nishida K, Nishie A. Computed tomography-derived assessment of respiratory impairment in thoracic scoliosis: Comparison between idiopathic and non-idiopathic etiologies. World J Radiol 2026; 18(6): 119975 [DOI: 10.4329/wjr.119975]
Nanae Tsuchiya, Satoko Yogi, Akira Yogi, Gyo Iida, Akihiro Nishie, Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Ginowan 9012720, Okinawa, Japan
Koji Yonemoto, Department of Biostatistics, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Ginowan 9012720, Okinawa, Japan
Takanao Shimabukuro, Kotaro Nishida, Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Ginowan 9012720, Okinawa, Japan
Author contributions: Tsuchiya N and Nishie A designed the research study; Tsuchiya N, Yogi S, Yogi A and Iida G performed the research; Shimabukuro T and Nishida K contributed clinical data; Yogi S and Tsuchiya N performed image analysis; Tsuchiya N and Yonemoto K performed statistical analysis; Tsuchiya N drafted the manuscript; and all authors contributed to manuscript revision and approve the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Clinical Research of University of the Ryukyus (Approval No. 23-2261-00-00-00).
Informed consent statement: Because this retrospective study used anonymized clinical data, the requirement for informed consent for study participation was waived by the Ethics Committee of Clinical Research of University of the Ryukyus.
Conflict-of-interest statement: Akihiro Nishie received funding from Canon Medical Systems. The present study did not receive any financial or technical support from this company.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Nanae Tsuchiya, MD, PhD, Department of Radiology, Graduate School of Medicine, University of the Ryukyus, Kiyuna 1076, Ginowan 9012720, Okinawa, Japan. nanaeasygoing@gmail.com
Received: February 14, 2026 Revised: April 16, 2026 Accepted: May 18, 2026 Published online: June 28, 2026 Processing time: 131 Days and 18.5 Hours
Abstract
BACKGROUND
Thoracic scoliosis causes complex three-dimensional deformities of the thoracic cage that can impair lung mechanics and airway geometry, leading to restrictive ventilatory dysfunction. Respiratory impairment differs by etiology, with non-idiopathic scoliosis often showing more severe and persistent deformity. Conventional pulmonary function testing provides global functional assessment but is frequently limited in patients with non-idiopathic scoliosis. Advances in chest computed tomography (CT) allow quantitative evaluation of lung volume and airway morphology, offering an alternative approach to assess respiratory function and the relationship to spinal deformity.
AIM
To investigate CT-derived airway morphology and respiratory function in thoracic scoliosis, focusing on etiologic differences and structure-function relationships.
METHODS
This retrospective observational study included 53 patients ≤ 30 years of age who underwent corrective surgery for thoracic scoliosis and had preoperative and postoperative CT examinations. Patients were classified into idiopathic (n = 25) or non-idiopathic scoliosis (n = 28). Spinal deformity parameters, lung volumes, predicted total lung capacity percentage (TLC%), and airway dimensions were quantified using CT. Group comparisons were performed using the Wilcoxon rank-sum test, correlations were determined using Spearman’s rank correlation, and pre- and postoperative changes were determined using the Wilcoxon signed-rank test.
RESULTS
Patients with non-idiopathic scoliosis had significantly more severe spinal deformities and a lower TLC% compared to patients with idiopathic scoliosis (median TLC%: 39% vs 64%, P < 0.001). The Cobb angle was negatively correlated with TLC% (ρ = -0.52, P = 0.004), lung volumes, and multiple airway parameters in patients with non-idiopathic scoliosis. Surgical correction significantly improved spinal alignment in both groups. CT-derived lung volume parameters did not show significant postoperative changes. In contrast, selective improvement was observed in the left bronchus.
CONCLUSION
CT-derived analysis showed differences in respiratory impairment between idiopathic and non-idiopathic scoliosis. Surgical correction improved alignment without immediate lung volume improvement, with selective changes in the left bronchus.
Core Tip: In thoracic scoliosis, computed tomography (CT)-based analysis demonstrated more pronounced respiratory impairment in non-idiopathic cases, particularly in those with neuromuscular involvement. Associations between spinal deformity and respiratory parameters varied between groups and should be interpreted as exploratory. Although surgical correction improved spinal alignment, CT-derived lung volumes did not show immediate postoperative improvement. However, selective enlargement of the left bronchus suggests a localized effect on airway compression. CT-based evaluation may provide useful complementary information, especially in patients unable to perform reliable pulmonary function testing.
