Document Detail


Correlation of Preoperative Deformity Magnitude and Pulmonary Function Tests in Adolescent Idiopathic Scoliosis.
MedLine Citation:
PMID:  21270699     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Study Design. Clinical study correlating preoperative pulmonary function tests (PFTs) to radiographic measures of thoracic deformity severity in adolescent idiopathic scoliosis (AIS) patients.Objective. To determine 1) the incidence of clinically relevant (<65% predicted value) pulmonary impairment in AIS patients; 2) if patients with more severe deformity have greater impairment of PFTs than those with lesser deformity; 3) the effect, if any, of juvenile onset deformity (onset < age10) on preoperative PFTs.Summary of Background Data. Patients with late-onset (adolescent) spinal deformity are generally believed to have no respiratory morbidity except in severe curves exceeding 100Methods. A large multi-center database of surgically-treated AIS patients with Lenke 1-4 curves was queried to report preoperative PFT's and correlate them with radiographic measures of coronal, sagittal, and axial plane deformitiesResults. 19% of 858 patients had <65% predicted FEV1 and FVC preoperatively, and had larger MT curves and greater axial rotation than those with predicted PFT values > 65%. Patients with MT curves >70, and especially >80; PT curves which were > 30 or structural; or T5-12 kyphosis <10 had significantly (p = .001 or <) lower FEV1 or FVC compared to those with less deformity. Axial plane deformity did not correlate with PFT impairment. Juvenile-onset patients had greater PFT impairment than AIS patients, along with slightly larger MT curves. Patients who were braced preoperatively had worse PFTs than those had no treatment prior to surgery.Conclusion. Preoperative PFTs are clinically impaired in 19% of AIS patients, and correlate significantly with the MT and sagittal plane deformity severity, and with PT curve severity to a lesser degree. PFTs do not correlate with degree of axial deformity.From a purely pulmonary standpoint, attention directed to coronal and sagittal plane deformity correction appears warranted, to address the specific deformities which are associated with PFT impairment.
Authors:
Ce Johnston; Bs Richards; Dj Sucato; Kh Bridwell; Lg Lenke; M Erickson;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-25
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Texas Scottish Rite Hospital, Dallas TX **Washington University School of Medicine, St. Louis MO ***Children's Hospital, Denver CO.
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