Structure-Respiration Function Relationships Before and After Surgical Treatment of Early-onset Scoliosis
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
Spine and chest wall deformities in children with early onset scoliosis (EOS) frequently impair respiratory function and postnatal growth of the lung. While a relationship between deformity and such impairment has been reported in children with adolescent idiopathic scoliosis it is not well understood in children with early-onset scoliosis (EOS).
We therefore describe (1) the preoperative relation between Cobb angle and forced vital capacity (FVC) in infants with EOS; (2) how changes in Cobb angle before and after surgery relate to changes in lung ventilation and perfusion in the right and left lungs.
We measured FVC in 10 children with EOS < 3 years old using the raised volume rapid thoracic compression (RVRTC) technique and correlated them with Cobb angles. We then measured right lung contributions to total lung ventilation and perfusion using lung scans before and 4 to 57 months after placement of vertical expandable prosthetic titanium ribs (VEPTRs) in 15 children with EOS and correlated changes in right lung function with postoperative changes in Cobb angles.
In children 4 to 57 months of age, preoperative FVC (mean value, 83%; range, 63%–109% of predicted values) did not correlate with Cobb angles (mean value, 56º; range, 14°–120º). In children 1.8 to 11.5 years old, right lung ventilation and perfusion were abnormal in eight and seven children, respectively, but neither ventilation nor perfusion predictably normalized despite reductions in Cobb angle postoperatively.
The data extend the age range of children with EOS whose Cobb angles correlate poorly with FVC preoperatively. The data are also consistent with reports that reduced Cobb angles after VEPTR insertion do not correlate with postoperative changes in respiratory function.
- Campbell R, Smith MD. Thoracic insufficiency syndrome and exotic scoliosis. J Bone Joint Surg Am. 2007;89(Suppl 1):108–122. CrossRef
- Campbell RM, Hell-Vocke AK. Growth of the thoracic spine in congenital scoliosis after expansion thoracoplasty. J Bone Joint Surg Am. 2003;85:409–420.
- Campbell RM Jr, Smith MD, Mayes TC, Mangos JA, Willey-Courand DB, Kose N, Pinero RF, Adler ME, Duong HL, Surber JL. The effect of opening wedge thoracostomy on thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis. J Bone Joint Surg Am. 2004;86:1659–1674.
- Mayer OH, Redding G. Early changes in pulmonary function after vertical expandable prosthetic titanium rib insertion in children with thoracic insufficiency syndrome. J Pediatr Orthop. 2009;29:35–38. CrossRef
- Montgomery-Downs HE, O’Brien LM, Gulliver TE, Gozal D. Polysomnographic characteristics in normal preschool and early school-aged children. Pediatrics. 2006;117:741–753. CrossRef
- Motoyama EK, Deeney VF, Fine GF, Yang CI, Mutich RL, Walczak SA, Moreland MS. Effects of lung function of multiple expansion thoracoplasty in children with thoracic insufficiency syndrome: a longitudinal study. Spine. 2006;31:284–290. CrossRef
- Motoyama EK, Yang CI, Deeney VF. Thoracic malformation with early-onset scoliosis: effect of serial VEPTR expansion thoracoplasty on lung growth and function in children. Paediatr Respir Rev. 2009;10:12–17. CrossRef
- 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;87:1937–1946. CrossRef
- Owange-Iraka JW, Harrison A, Warner JO. Lung function in congenital and idiopathic scoliosis. Eur J Pediatr. 1984;142:198–200. CrossRef
- Redding G, Song K, Inscore S, Effmann E, Campbell R. Lung function asymmetry in children with congenital and infantile scoliosis. Spine J. 2008;8:639–644. CrossRef
- Striegl A, Chen ML, Kifle Y, Song K, Redding G. Sleep-disordered breathing in children with thoracic insufficiency syndrome. Pediatr Pulmonol. 2010;45:469–474. CrossRef
- Thompson GH, Akbarnia BA, Campbell R. Growing rod techniques in early-onset scoliosis. J Pediatr Orthop. 2007;27:354–361. CrossRef
- Structure-Respiration Function Relationships Before and After Surgical Treatment of Early-onset Scoliosis
Clinical Orthopaedics and Related Research®
Volume 469, Issue 5 , pp 1330-1334
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors