Document Detail


Correlation of spine deformity, lung function, and seat pressure in spina bifida.
MedLine Citation:
PMID:  21125362     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spinal deformity, a common problem in children with myelodysplasia, is associated with alterations in pulmonary function and sitting balance. Sitting imbalance causes areas of high pressure in patients already at high risk for developing pressure ulcers due to insensate skin.
QUESTIONS/PURPOSES: We asked: Does spinal deformity affect pulmonary function tests in children with myelodysplasia? Does the magnitude of spinal curvatures and pelvic obliquity affect seating pressures? Does spinal deformity and seated pressures correlate with a history of pressure ulcers?
PATIENTS AND METHODS: We retrospectively reviewed 32 patients with myelodysplasia and scoliosis (mean age, 14 years). The mean thoracic scoliosis was 64° with a mean pelvic obliquity of 15°. The mean forced vital capacity was 59% of predicted. The mean of the average and peak seated pressures were 24 and 137 mm Hg, respectively. We examined spinal radiographs, pulmonary function tests, and seated pressure maps and evaluated correlations of spinal deformity measures, pulmonary function, and seated pressures.
RESULTS: The thoracic scoliosis inversely correlated with lung volume and weakly related with only the forced midexpiratory volume parameter (R(2) = 31%). The curve magnitude was associated with % seated area with pressures of 38 to 70 mm Hg while lesser degrees of pelvic obliquity were associated with % seating area with pressures of less than 38 mm Hg (R(2) = 25% and 24%, respectively). A history of pressure ulcers did not correlate with any spinal deformity or seated pressure measures.
CONCLUSIONS: All patients displayed a reduced forced vital capacity, but this reduction was not related to increasing scoliosis. The smaller scoliosis curves and lesser degrees of pelvic obliquity were associated with larger areas of low seated pressures.
Authors:
Jayesh Patel; Janet L Walker; Vishwas R Talwalkar; Henry J Iwinski; Todd A Milbrandt
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-01     Completed Date:  2011-06-07     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1302-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Analysis of Variance
Buttocks / physiopathology*
Forced Expiratory Volume
Humans
Kentucky
Lung / physiopathology*
Lung Volume Measurements
Maximal Midexpiratory Flow Rate
Meningomyelocele / complications*,  physiopathology,  radiography
Peak Expiratory Flow Rate
Posture*
Pressure
Pressure Ulcer / etiology*,  physiopathology
Regression Analysis
Retrospective Studies
Risk Assessment
Risk Factors
Scoliosis / etiology*,  physiopathology,  radiography
Severity of Illness Index
Spinal Dysraphism / complications*,  physiopathology,  radiography
Spine / abnormalities*,  physiopathology,  radiography
Spirometry
Vital Capacity
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