Korean J Thorac Cardiovasc Surg 2018; 51(4): 254-259  https://doi.org/10.5090/kjtcs.2018.51.4.254
Thoracic Scoliosis in Patients with Primary Spontaneous Pneumothorax
Yeiwon Lee, M.D.1, Young Jin Kim, M.D., Ph.D.1, Han Young Ryu, M.D.1, Gwan Woo Ku, M.D.1, Tae Yun Sung, M.D.2, Yoo Sang Yoon, M.D., Ph.D.3, Tae-Kyun Kim, M.D.4
Departments of 1Thoracic and Cardiovascular Surgery and 2Anesthesiology and Pain Medicine, Konyang University College of Medicine, 3Department of Thoracic Surgery, Dongnam Institute of Radiological and Medical Science, 4Department of Orthopaedic Surgery, Konyang University College of Medicine
Corresponding author: Young Jin Kim, Department of Thoracic and Cardiovascular Surgery, Konyang University Hospital, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea
(Tel) 82-42-600-9150 (Fax) 82-42-600-6657 (E-mail) kyjcs@kyuh.ac.kr
Received: October 19, 2017; Revised: October 26, 2017; Accepted: November 6, 2017.; Published online: August 5, 2018.
© The Korean Journal of Thoracic and Cardiovascular Surgery. All rights reserved.

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Abstract
Background: Primary spontaneous pneumothorax (PSP) affects patients without clinically apparent lung disorder found in tall and thin young male. Scoliosis refers to curves exceeding 10° Cobb angle observed through chest X-ray and affects 2% to 4% of adolescents. Both conditions are commonly encountered in primary health care setting. The aim of this study is to access the correlation of thoracic scoliosis and PSP in adolescent.
Methods: A retrospective analysis was conducted for patients diagnosed for PSP in Konyang University Hospital between January 2010 and March 2017. Chest X-rays of 222 patients and 155 normal control (NC) cases were reviewed to measure the Cobb angle. Greater than 10° of Cobb angle is diagnosed as scoliosis.
Results: Scoliosis in patient with PSP has higher incidence than that of NC group (p<0.001). Median value of Cobb angle is 12.9° in PSP group and 14.7° in NC group. Directional relationship between scoliosis and pneumothorax in PSP group is also observed; 40.5% cases are ipsilateral and 59.5% are contralateral.
Conclusion: PSP patients tend to have thoracic scoliosis more commonly compared with normal healthy adolescent. Scoliosis may contribute to heterogeneity of alveolar pressure which exacerbates subpleural bleb formation that can cause pneumothorax. The causal relationship is unclear and further studies are needed in the future.
Keywords: Thorax, Pneumothorax, Scoliosis


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