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Pulmonary Function in Middle-Aged Patients With Idiopathic Scoliosis With Onset Before the Age of 10 Years

  • Long-Term Follow-Up Case Series
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Abstract

Study Design

Consecutive patients with idiopathic scoliosis diagnosed before age 10 attended a clinical follow-up at least 10 years after treatment.

Objectives

To evaluate the pulmonary function in adulthood after treatment with brace or surgery before maturity.

Summary of Background Data

Long-term studies of these patients have not been published.

Methods

One hundred twenty-four patients (69% of the original group) underwent radiography, spirometry, and answered symptom questionnaires. A total of 73 patients had spirometries before treatment enabling longitudinal evaluation. Overall, 68 braced only (BT) and 56 surgically treated (ST) were analyzed in detail. A population-based control group was used.

Results

At follow-up, the mean age was 41. 5 years and the mean curve size 36 degrees (26% of the curves >45 degrees). The full patient group had a significantly reduced pulmonary function (as measured by the forced vital capacity [FVC], percentage of predicted) compared with the control group, mean 85% versus 102% (p <. 0001). Both subgroups of BT and ST patients showed a significant reduction, more in the ST than the BT group (means 79% and 90%, respectively, p =. 0003). The most important risk factor for a low lung function at follow-up was a low initial FVC value. Initial curve size correlated with pulmonary function both before treatment and at follow-up. Most surgically treated patients, who had larger curves before treatment, did not improve their pulmonary function after surgery.

Conclusions

Both braced and surgically treated patients had reduced pulmonary function at the age of around 40 years. The pulmonary function did not worsen over time in most patients. There was no difference in terms of symptoms between patient groups and controls. Initial curve size was found to be of great importance for pulmonary function. Initial spirometry and follow-up in selected patients is important.

Level of Evidence

III.

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References

  1. Nilsonne U, Lundgren KD. Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand 1968;2:456–65.

    Article  Google Scholar 

  2. Nachemson A. A long term follow-up study of non-treated scoliosis. Acta Orthop Scand 1968;2:466–76.

    Article  Google Scholar 

  3. Pehrsson K, Larsson S, Oden A, Nachemson A. Long-term follow-up of patients with untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine 1992;2:1091–6.

    Article  Google Scholar 

  4. Davies G, Reid L. Growth of the alveoli and pulmonary arteries in childhood. Thorax 1970;2:669–81.

    Article  Google Scholar 

  5. Narayanan M, Owers-Bradley J, Beardsmore CS, et al. Alveolariza-tion continues during childhood and adolescence: new evidence from helium-3 magnetic resonance. Am J Respir Crit Care Med 2012;2:186–91.

    Article  Google Scholar 

  6. Kennedy JD, Robertson CF, Hudson I, Phelan PD. Effect of bracing on respiratory mechanics in mild idiopathic scoliosis. Thorax 1989;2:548–53.

    Article  Google Scholar 

  7. Katsaris G, Loukos A, Valavanis J, et al. The immediate effect of a Boston brace on lung volumes and pulmonary compliance in mild adolescent idiopathic scoliosis. Eur Spine J 1999;2:2–7.

    Article  Google Scholar 

  8. Ferrari K, Goti P, Sanna A, et al. Short-term effects of bracing on exercise performance in mild idiopathic thoracic scoliosis. Lung 1997;2:299–310.

    Article  Google Scholar 

  9. 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;2:388–93.

    Article  Google Scholar 

  10. Redding GJ, Mayer OH. Structure-respiration function relationships before and after surgical treatment of early-onset scoliosis. Clin Or-thop Relat Res 2011;2:1330–4.

    Article  Google Scholar 

  11. Redding G. Early onset scoliosis: a pulmonary perspective. Spine Deform 2014;2:425–9.

    Article  Google Scholar 

  12. Skaggs DL, Guillaume T, El-Hawary R, et al. Early Onset Scoliosis Consensus Statement, SRS Growing Spine Committee, 2015. Spine Deform 2015;2:107.

    Article  Google Scholar 

  13. Risser J. The iliac apophysis: an invaluable sign in the management of scoliosis. Clin Orthop 1958;2:111–9.

    Google Scholar 

  14. Greulich W, Pyle S. Radiographic Atlas of the Skeletal Development of the Hand and Wrist. 2nd ed. Stanford, CA: Stanford University Press; 1950.

    Google Scholar 

  15. Bunnell WP. An objective criterion for scoliosis screening. J Bone Joint Surg [Am] 1984;2:1381–7.

    Article  Google Scholar 

  16. Cobb J. Technique for study of scoliosis. In: Blount WP, American Academy of Orthopaedic Surgeons, editors. AAOS Instructional Course Lectures. Ann Arbor, MI: J. Edwards Publisher Inc; 1948. p. 261–75.

    Google Scholar 

  17. Quanjer PH, Stanojevic S, Cole TJ, et al. ERS Global Lung Function Initiative. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012;2:1324–43.

    Article  Google Scholar 

  18. Lindh M, Bjure J. Lung volumes in scoliosis before and after correction by the Harrington instrumentation method. Acta Orthop Scand 1975;2:934–48.

    Article  Google Scholar 

  19. Nickerson BG, Lemen RJ, Gerdes CB, et al. Within-subject variability and per cent change for significance of spirometry in normal subjects and in patients with cystic fibrosis. Am Rev Respir Dis 1980;2:859–66.

    Google Scholar 

  20. Fry J, Fleicher C, Oswald N. Chronic bronchitis in Great Britain. A national survey carried out by the respiratory diseases study group of the college of general practitioners. Br Med J 1961;2:973–9.

    Article  Google Scholar 

  21. Stenton C. The MRC breathlessness scale. Occup Med (Lond) 2008;2:226–7.

    Article  Google Scholar 

  22. Lotvall J, Ekerljung L, Ronmark EP, et al. West Sweden Asthma Study: prevalence trends over the last 18 years argues no recent increase in asthma. Respir Res 2009;2:94.

    Article  Google Scholar 

  23. Ekerljung L, Ronmark E, Lotvall J, et al. Questionnaire layout and wording influence prevalence and risk estimates of respiratory symptoms in a population cohort. Clin Respir J 2013;2:53–63.

    Article  Google Scholar 

  24. Cerveri I, Corsico AG, Accordini S, et al. Underestimation of airflow obstruction among young adults using FEV1/FVC <70% as a fixed cut-off: a longitudinal evaluation of clinical and functional outcomes. Thorax 2008;2:1040–5.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Aina J. Danielsson MD, PhD

  2. Department of Orthopedics, Sahlgrenska University Hospital, Bruna stråket 11, S-413 45, Gothenburg, Sweden

    Aina J. Danielsson MD, PhD

  3. Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Linda Ekerljung PhD

  4. Department of Respiratory Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Kerstin Lofdahl Hallerman MD, PhD

  5. Department of Respiratory Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

    Kerstin Lofdahl Hallerman MD, PhD

Authors
  1. Aina J. Danielsson MD, PhD
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  2. Linda Ekerljung PhD
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  3. Kerstin Lofdahl Hallerman MD, PhD
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Corresponding author

Correspondence to Aina J. Danielsson MD, PhD.

Additional information

Author disclosures: AJD (none); LE (none); KLH (none).

Research Ethics Committee: the Human Research Ethics Committee at the Medical Faculty at Gothenburg University, Sweden, approved the study (no. 081/07).

Funding sources: Funds were received as total or partial support for the research in this article from the Gothenburg Medical Society, the Neubergh Foundations, and through “the Agreement concerning research and education of doctors.” No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Danielsson, A.J., Ekerljung, L. & Hallerman, K.L. Pulmonary Function in Middle-Aged Patients With Idiopathic Scoliosis With Onset Before the Age of 10 Years. Spine Deform 3, 451–461 (2015). https://doi.org/10.1016/j.jspd.2015.07.007

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  • DOI: https://doi.org/10.1016/j.jspd.2015.07.007

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