Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients

Abstract

RESULTSThe mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1-L3 than at T6-T8 or T9-T12 (p = 0.006).CONCLUSION Lung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients.

Respiratory morbidity in children with cerebral palsy: an overview

“…The increased work of breathing in combination with the above‐mentioned changes predispose to respiratory failure. Alveolar hypoventilation, hypercapnia, and hypoxaemia cause pulmonary hypertension, cor pulmonale, and eventually right‐sided heart failure …”

“…Sewell et al report a postoperative improvement in activity and participation in children with CP (GMFCS levels IV and V) and significant scoliosis. In patients with idiopathic scoliosis, surgery may improve pulmonary function, but these data are lacking concerning patients with CP, although this is one of the goals for this surgery . Another purpose for scoliosis surgery in patients with CP is to decrease the incidence of pneumonia; however, there is little evidence that this is the case .…”

“…Alveolar hypoventilation, hypercapnia, and hypoxaemia cause pulmonary hypertension, cor pulmonale, and eventually right-sided heart failure. 43 The general reported incidence of scoliosis in CP is 20% to 25%, but the risk increases from a very low risk in patients in GMFCS levels I and II to 50% with a more severe curve and is more likely to progress in patients in GMFCS levels IV and V. Scoliosis is progressive in nature and in these patients it may progress even after growth has ceased, which warrants early treatment. 44,45 Conservative treatment options consist of seating arrangements and braces to provide external support to the spine.…”

“…In patients with idiopathic scoliosis, surgery may improve pulmonary function, but these data are lacking concerning patients with CP, although this is one of the goals for this surgery. 43,47 Another purpose for scoliosis surgery in patients with CP is to decrease the incidence of pneumonia; however, there is little evidence that this is the case. 47 A recent systematic review concluded that there is only limited high-quality evidence for outcomes after scoliosis surgery in children with CP and that this procedure is associated with a moderately high complication rate.…”

Severe scoliosis in an adolescent, benefits of early detection: a case report

“…Thoracic cage deformity is associated with spinal deformity in AIS. 19 The higher the magnitude of the curvature, the more anatomical alterations of the thoracic cavity. This may lead to lung compression resulting in less volume and compliance.…”