{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:09:02Z","timestamp":1793650142000,"version":"4.5.1"},"reference-count":40,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"name":"K2M Inc."}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2018,1,31]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>High prevalence of obstructive lung disease has been reported in patients undergoing surgical correction of thoracic scoliosis. Airway narrowing due to spine morphology is analysed as a contributing factor.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Preoperative surgical planning CTs of 34 patients with right-sided thoracic scoliosis (age: 17.6\u00b19.0) were retrospectively analysed and compared with 15 non-scoliotic controls (age: 16.3\u00b15.1). Three-dimensional models of spine and airway lumen were reconstructed. Based on thoracic sagittal profile, patients were divided into hypokyphosis (HypoS: &lt;10\u00b0), normal kyphosis (NormS: \u226510\u00b0 and &lt;40\u00b0) and hyperkyphosis (HyperS: \u226540\u00b0) groups. Lumen area of bronchi, bifurcation angles and minimum spine\u2013airway distance were measured. Pulmonary function tests were correlated to scoliosis, kyphosis and lumen area.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Loss of kyphosis led to proximity between bronchus intermedius (BI) and spine. HypoS (NormS) had lumen area reductions in the right main bronchus of 29% (19%), BI of 45% (23%), right middle lobar bronchus of 46% (32%) and right lower lobe bronchus (RLL7) of 66% (37%), respectively (P&lt;0.05). The lower right superior segmental bronchus was reduced across all scoliotic groups (P&lt;0.05). Airways were displaced caudal by 0.65\u00b10.45\u2009vertebra in patients with scoliosis. Loss of kyphosis correlated negatively with forced expiratory volume in 1 s\/forced vital capacity (FEV<jats:sub>1<\/jats:sub>\/FVC), FVC\/(FVC predicted) and FEV<jats:sub>1<\/jats:sub>\/(FEV<jats:sub>1<\/jats:sub> predicted) (P&lt;0.01). Lumen area of trachea, right upper lobar bronchus, BI and RLL7 correlated negatively with FEV<jats:sub>1<\/jats:sub>\/FVC. BI and RLL7 narrowing were strong predictors of FVC and FEV<jats:sub>1<\/jats:sub> loss (P&lt;0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Right-sided main stem airways are narrowed in HypoS and NormS. Loss of kyphosis leads to narrowing of BI and its trifurcation. FEV<jats:sub>1<\/jats:sub>\/FVC correlated negatively with airway narrowing, implying an obstructive element to lung function impairment in patients with scoliosis and hypokyphosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjresp-2017-000264","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T02:10:16Z","timestamp":1522030216000},"page":"e000264","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Effect of idiopathic thoracic scoliosis on the tracheobronchial tree"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5665-4519","authenticated-orcid":false,"given":"James","family":"Farrell","sequence":"first","affiliation":[{"name":"School of Engineering, University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique","family":"Garrido","sequence":"additional","affiliation":[{"name":"Scottish National Spine Deformity Service, Royal Hospital for Sick Children, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,3,25]]},"reference":[{"key":"2025083110175443000_5.1.e000264.1","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-012-0457-4"},{"key":"2025083110175443000_5.1.e000264.2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1097\/00007632-200203150-00008","article-title":"Curve prevalence of a new classification of operative adolescent idiopathic scoliosis","volume":"27","author":"Lenke","year":"2002","journal-title":"Spine"},{"key":"2025083110175443000_5.1.e000264.3","unstructured":"Wiesel MD , Sam W , Bell MD . 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