.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Frequency of Deranged Pulmonary Function Tests in patients with Adolescent Idiopathic Scoliosis
Keywords:
AIS-Adolescent idiopathic scoliosis, Pulmonary function tests, FVC-Forced vital capacity, Cobb Angle.Abstract
Objectives: The clinical study was carried out to establish the frequency of deranged pulmonary function tests (PFTs) in patients suffering from adolescent idiopathic scoliosis (AIS).
Methodology: All the patients consulting to the OPD of the department with scoliosis were gone through the diagnosis of AIS as per operational definition and patients complying the criteria of inclusion were included in the study. A comprehensive clinical history was obtained succeeded by detailed bodily and systemic examination. Cobb angle was measured using standard technique and type of scoliosis was classed according to standard Lenke Classification system. All patients were then sent to pulmonology department for assessment of derangement in pulmonary function tests (PFTs) and derangement in PFTs was defined as per operational definitions.
Results: Out of 88 patients, 76.1% were males and 23.9% were females. Mean age was 13.39 ± 1.86 years and mean Cobb angle was 45.03 ± 16.2 ºs. Maximum patients were of 10-12 years age i.e. 35.2%. Most patients (34.1%) were observed with 41-55 º Cobb angles. 30.7% patients were with Type 2 curve. 38.6% patients were observed with moderately severe deformity, followed by 28.4% patients with moderate severity. The curve was structural in 86.4% patients while non-structural in 13.6% patients. Deranged PFTs were observed in total 64.8% patients.
Conclusion: Pulmonary Function Tests (PFTs) like FVC and FEV1 are highly associated with AIS and preoperative PFTs are very helpful in planning and management of the surgery of patients with scoliosis.
References
1. Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis. BMJ. 2013;346:f2508.
2. Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Dtsch Arztebl Int. 2010;107(49):875–83 quiz 884.
3. Negrini S, Donzelli S, Aulisa AG, Czaprowski D, Schreiber S, de Mauroy JC, Diers H, Grivas TB, Knott P, Kotwicki T, et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis Spinal Disord. 2018;13:3.
4. Asher MA, Burton DC. Adolescent idiopathic scoliosis: natural history and long term treatment effects. Scoliosis. 2006;1(1):2.
5. Bettany J, Turnbull D, Ng SY, Webb R. Management of spinal deformities and evidence of treatment effectiveness. Open Orthop J. 2017;11:1521.
6. Terry Canale S, James Beaty H. Campbell's Operative Orthopedics. 12th edition, Mosby, Philadelphia. 2013;II:1692.
7. Issac E, Menon G, Vasu BK, George M, Vasudevan A. Predictors of postoperative ventilation in scoliosis surgery: a retrospective analysis. Anesth Essays Res. 2018;12(2):407.
8. Tsiligiannis T, Grivas T. Pulmonary function in children with idiopathic scoliosis. Scoliosis. 2012;7:7.
9. Konieczny MR, Senyurt H and Krausp R. Epidemiology of adolescent idiopathic scoliosis. J Child Orthop 2013; 7: 3–9.
10. Koumbourlis AC. Scoliosis and the respiratory system. Paediatr Resp Revi 2006;7(2):152-60.
11. Agabegi SS, Kazemi N, Sturm PF, Mehlman CT. Natural history of adolescent idiopathic scoliosis in skeletally mature patients: a critical review. J Am Acad Orthop Surg. 2015;23(12):714.
12. White H, Wallace J, King J,;sburger S, Milbrandt T, Iwinski H. A prospective comparison of pulmonary function using traditional and kinematic measures in children with and without adolescent idiopathic scoliosis. Spine Deform. 2015;3(6):554–9.
13. Flores F, Cavaleiro J, Lopes AA, Ribeiro F, Oliveira A. Preoperative pulmonary function and respiratory muscle strength in Portuguese adolescents with idiopathic scoliosis. Rev Port Pneumol. 2016;22(1):52.
14. Pehrsson K, Danielsson A, Nachemson A. Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment. Thorax 2001; 56(5): 388-93.
15. Tambe AD, Panikkar SJ, Millner PA, Tsirikos AI. Current concepts in the surgical management of adolescent idiopathic scoliosis. Bone Joint J.2018;100-B(4):415.
16. Newton PO, Faro FD, Gollogly S, Betz RR, Lenke LG, Lowe TG. Results of preoperative pulmonary function testing of adolescents with idiopathic scoliosis. A study of six hundred and thirty-one patients. J Bone Joint Surg Am. 2005;87(9):1937–46.
17. Yu CG, Grant CA, Izatt MT, Labrom RD, Askin GN, Adam CJ, Little JP. Change in lung volume following thoracoscopic anterior spinal fusion surgery: a 3-dimensional computed tomography investigation. Spine (Phila Pa 1976). 2017;42(12):909–16.
18. Yaszay B, Bastrom TP, Bartley CE, Parent S, Newton PO. The effects of the three-dimensional deformity of adolescent idiopathic scoliosis on pulmonary function. Eur Spine J. 2017;26(6):1658–64.
19. Dreimann M, Hoffmann M, Kossow K, Hitzl W, Meier O, Koller H. Scoliosis and chest cage deformity measures predicting impairments in pulmonary function: a cross-sectional study of 492 patients with scoliosis to improve the early identification of patients at risk. Spine (Phila Pa 1976). 2014;39(24):2024–33. .
20. Yaszay B, Jankowski PP, Bastrom TP, Lonner B, Betz R, Shah S, Asghar J, Miyanji F, Samdani A, Newton PO. Progressive decline in pulmonary function 5 years post-operatively in patients who underwent anterior instrumentation for surgical correction of adolescent idiopathic scoliosis. Eur Spine J. 2019;28(6):1322–30.
21. Lopes AA, Flores F, Ribeiro F, Oliveira A. Pulmonary function and respiratory muscle strength after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis. Pulmonology. 2018;24(3):194–5.
22. Lao L, Weng X, Qiu G, Shen J. The role of preoperative pulmonary function tests in the surgical treatment of extremely severe scoliosis. J Orthop Surg Res. 2013;8:32.
23. Abdelaal AAM, Abd El Kafy EMAES, Elayat MSEM, Sabbahi M, Badghish MSS. Changes in pulmonary function and functional capacity in adolescents with mild idiopathic scoliosis: observational cohort study. J Int Med Res. 2018 Jan;46(1):381-391.
24. Udink ten Cate FE, van Royen BJ, van Heerde M, Roerdink D, Plotz FB. Incidence and risk factors of prolonged mechanical ventilation in neuromuscular scoliosis surgery. J Pediatr Orthop B. 2008;17:203–6.
25. Kang GR, Suh SW, Lee IO. Preoperative predictors of postoperative pulmonary complications in neuromuscular scoliosis. J Orthop Sci. 2011;16:139–47.
26. Almenrader N, Patel D. Spinal fusion surgery in children with nonidiopathic scoliosis: Is there a need for routine postoperative ventilation? Br J Anaesth. 2006;97:851–7.
27. Yuan N, Skaggs DL, Dorey F, Keens TG. Preoperative predictors of prolonged postoperative mechanical ventilation in children following scoliosis repair. Pediatr Pulmonol. 2005;40:414–9.
28. Gibson PR. Anaesthesia for correction of scoliosis in children. Anaesth Intensive Care. 2004;32:548–59.
29. Bashir K, Sabir N, Zia-ur-Rehman, Aziz MO, Awan MAA, Dogar A et al. Comparative Analysis of Pulmonary Function Impairment in Adolescent Idiopathic vs. Congenital Scoliosis. Pak J Med Health Sci. Feb.2022;16 (2):135-136.
30. Wang Y, Yang F, Wang D, Zhao H, Zhanjun Ma, Peifen Ma. Correlation analysis between the pulmonary function test and the radiological parameters of the main right thoracic curve in adolescent idiopathic scoliosis. J Orthop Surg Res. 2019;14:443.
31. Rekha YB, Prakash RS. Evaluation of pulmonary function in adolescent idiopathic thoracic scoliosis. Int J Ortho Sci. 2017;3(2):665.
