Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis

Bjure, J.; Grimby, Gunnar; Kasalický, J; Lindh, Margareta Gonzalez; Nachemson, Alf

doi:10.1136/thx.25.4.451

Cited by 60 publications

(27 citation statements)

References 17 publications

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“…Both these methods assume a normal relationship between theoretical We have demonstrated an inverse relationship between the angle and the VC, percent predicted VC, the TLC, and the precent predicted TLC (Table III). These results are qualitatively similar to earlier observations that the greatest reductions in VC and TLC were seen when the angle was large (34)(35)(36). The apparent different effects of scoliosis on the FRC previously observed (7,8) have been resolved by this study, in which both the FRC and the percent predicted FRC were inversely related to the angle.…”

Section: Discussionsupporting

confidence: 81%

Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide.

Kafer¹

1975

J. Clin. Invest.

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Section: Discussionsupporting

confidence: 81%

Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide.

Kafer¹

1975

J. Clin. Invest.

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“…The data in the literature, as well as the result of our research, show that in ky phoscoliosis a typical restrictive respirato ry dysfunction can be seen, with a reduc tion of the vital capacity [1,2,10,12,19,20,25,26]. The reduction of the vital ca pacity is greater than the reduction of the residual volume, with a consequent in crease of the RV/TLC ratio.…”

Section: Discussionmentioning

confidence: 69%

“…With regard to kyphoscoliotic patients with bronchitic superimposition [6,21,28], the respiratory obstructive situ ation could be determined by the bronchi al infective component, rather than by the kyphoscoliosis itself. In other cases [2,10,12,18,20,26] it is necessary to notice that the indices of bronchial obstruction ap pear in few of the subjects belonging to the respective case studies and with values which are not as altered as the indices of the restrictive ventilatory disturbances are. In this type of respiratory pathology many factors are operating simultaneously (de gree, type and segment of curvature of the vertebral column, age of the patients and the period of time during which the bony deformation has acted upon the respirato ry apparatus).…”

Section: Discussionmentioning

confidence: 99%

Alveolar-Arterial Gradients and Small Airways in Kyphoscoliosis

Cosentino¹,

Ghai²,

Garbagni³

1983

Respiration

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In 14 patients, kyphoscoliotics, at the time without cardiorespiratory diseases, of average age 28 years ± 17 (range 12–64), the average values for the vital capacity was 79.6 ± 21.2% (range 49–125), for the Tiffeneau Index was 77.9% ± 10.3% (range 56–91), for the RV/TLC ratio was 39.6% ± 10.8% (range 18–56), for the MEF 25 was 2,192.8 ± 732.1 ml/s (range 1,300–3,800), for the MEF 50 was 3,689.3 ± 1,310.9 ml/s (range 1,750–5,500). The average value for the PaO₂ was 90.3 ± 8.3 mm Hg (range 75–109), and for the PaCO₂ 35.3 ± 4.66 mm Hg (range 27.8–46). The average value for the alveolar-arterial gradient of O₂ was 11.96 ± 7.37 mm Hg (range 0.74–27.94) and for the arterial-alveolar gradient of CO₂ 2.30 ± 2.41 mm Hg (range 0.22–9.98). The average value for the CO transfer was 20.06 ± 6.84 ml/min/mm Hg (range 8–31.4). As the angle of scoliosis and the age of the subject increase, the vital capacity and the Tiffeneau Index decrease, the RV/TLC ratio and the respiratory rate increase, the MEF 25, the MEF 50, the PaO₂, and the transfer of CO decrease, while PaCO₂ increases. The alveolar-arterial gradient of 0₂ and the arterial-alveolar gradient of CO₂ increase as the angle of scoliosis increases. The data so obtained show, therefore, that in kyphoscoliosis a restrictive type of respiratory dysfunction appears, along with hypoxemia due to alveolar hypoventilation and disturbances in diffusion and in the ventilation-perfusion ratio.

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“…(8) Increased frequency of respiratory impairment was also found in 50 patients aged 11-78 years with untreated idiopathic scoliosis, especially those with a severe degree of scoliosis. (27) Alternatively, Smyth et al found that the strength of respiratory muscles to achieve maximum respiratory pressure is a more important determinant of developing respiratory impairment than the degree of spinal curvature. (9) Impaired pulmonary function was also observed in patients with mild, idiopathic scoliosis.…”

Section: Discussionmentioning

confidence: 99%

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

Johari¹,

Sharifudin²,

Rahman³

et al. 2016

smedj

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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.

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Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis

Cited by 60 publications

References 17 publications

Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide.

Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide.

Alveolar-Arterial Gradients and Small Airways in Kyphoscoliosis

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

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