Severe hyperkyphosis reduces the aerobic capacity and maximal exercise tolerance in patients with Scheuermann disease

Lorente, Alejandro; Barrios, Carlos; Lorente, Rafael; Tamariz, Rocío; Burgos, Jesús

doi:10.1016/j.spinee.2018.07.002

Cited by 6 publications

(7 citation statements)

References 23 publications

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“…Analysing pulmonary function with basal spirometry, the occurrence of moderate or severe restrictive lung disease in SK patients was found to be directly related to the magnitude of kyphotic deformity 1 , 2 . These findings were recently verified by Lorente et al 3 , who confirmed that both VO 2 max and VEmax values decrease as hyperkyphosis increases in patients with Scheuermann’s disease. This observation reflects the restrictive influence that hyperkyphosis has on ventilatory mechanisms in SK patients.…”

Section: Discussionsupporting

confidence: 61%

“…However, in the current study there was no relationship between the magnitude of the sagittal correction of the thoracic spine and the improvement of the respiratory function. In fact, SK patients presented after surgery lower kyphotic magnitudes that the Lorente’s cohort of conservative treated SK cases showing also worse respiratory tolerance to maximal exercise 3 .…”

Section: Discussionmentioning

confidence: 80%

“…This study is the first to describe the impact of surgical correction of thoracic hyperkyphosis on the cardiorespiratory functional restrictions consistently found in patients with moderate-severe Scheuermann’s disease. According to previous studies, patients with more than 75º Scheuermann’s hyperkyphosis show clear intolerance to maximal exercise 3 . VO 2 max, VEmax and the HR/VO 2 quotient (an indicator of cardiovascular efficiency) were severely deteriorated in patients with more than 75° of kyphosis.…”

Section: Discussionmentioning

confidence: 90%

“…The CPETs were conducted under standard conditions of temperature, humidity, and atmospheric pressure 6 . An incremental Bruce exercise protocol for a treadmill was adapted for an ergometer and used following the specifications in a previous study 3 . Briefly, the protocol started with a 5-min warm-up at a speed of 0.75 m/s.…”

Section: Methodsmentioning

confidence: 99%

“…Recently, ventilatory functional restrictions were evaluated in patients with Scheuermann’s disease during a maximal exercise tolerance test 3 . Although there were no differences between SK patients and healthy individuals in any of the basal parameters, maximal aerobic power (VO 2 max) and ventilatory capacity (VEmax) were severely deteriorated in SK patients with more than 75° of kyphosis, showing clear respiratory inefficiency.…”

Section: Introductionmentioning

confidence: 99%

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Cardiorespiratory function of patients undergoing surgical correction of Scheuermann's hyperkyphosis

Vera

Lorente

Burgos³

et al. 2021

Sci Rep

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The aim of this study was to analyze the impact of surgical correction of the thoracic deformity on the cardiorespiratory function of patients with moderate-severe Scheuermann’s hyperkyphosis (SK). A series of 23 adolescents with SK who underwent surgery through an only posterior approach using all pedicle screw constructs were included in the study. Cardiorespiratory parameters were measured during a maximal exercise tolerance test before and 2 years after surgery. Heart rate, oxygen saturation (SatO2), maximum oxygen uptake (VO2 max), ventilatory capacity at maximal exercise (VEmax), and energy costs were recorded. There were statistically significant differences in the forced vital capacity (FVC) (P < 0.05), total VO2max (ml/min) (P < 0.01), maximum expired volume (VEmax) per minute (P < 0.01) and cardiovascular efficiency (HR/VO2 ratio) (P < 0.05). None of these changes were clinically relevant. There were no changes in the VO2max per kg of body mass. The magnitude of the kyphosis correction did not correlate with the change in normalized VO2max or VEmax. In conclusion, patients with moderate-severe SK improve their baseline respiratory limitations and the tolerance to maximum exercise 2 years after surgery. However, the slight cardiorespiratory functional improvements should not necessarily be attributed to the surgery, and could also be caused solely by the residual growth of the lungs and thorax. Furthermore, respiratory functional changes are under thresholds considered as clinically relevant.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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