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A Comparison of Maximal Voluntary Ventilation and Forced Vital Capacity in Adolescent Idiopathic Scoliosis Patients

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Abstract

Study Design

Prospective, single center.

Objective

To compare maximal voluntary ventilation (MVV) and forced vital capacity (FVC) testing in the outpatient scoliosis clinic to determine their relative feasibility and sensitivity in assessing pulmonary function in the AIS population.

Summary of Background Data

Evidence of compromised pulmonary function in patients with severe AIS is well established. The American Thoracic Society (ATS) has established criteria for the reliability and accuracy of pulmonary function tests (PFTs), including MVV and FVC.

Methods

A total of 91 AIS patients with thoracic curves of 20° or greater were enrolled in the orthopedic clinic. Patients performed PFTs using the CareFusion MicroLoop Spirometer. MVV and FVC values were collected. Results were considered reliable or “passing” when ATS spirometer guidelines were met.

Results

Eighty-seven of the 91 patients (96%) met ATS criteria for the MVV test and 43 of the 91 patients (47%) met criteria for the FVC test. Both MVV (r = –0.41, p < .01) and FVC (r = –0.37, p = .01) were significantly correlated with thoracic Cobb angle. The percentile predicted (%predicted) MVV (r = –0.24, p = .03) and %predicted FVC (r = –0.32, p = .04) were also significantly correlated with thoracic Cobb angle. Of those who passed both tests (42/91 patients), 26% had abnormal MVV results with normal FVC results, and 5% had abnormal FVC results with normal MVV results.

Conclusion

MVV and FVC correlated closely with Cobb angle. Twice as many AIS patients could perform an MVV test compared with an FVC test. MVV seems to be a more practical and sensitive PFT than FVC for assessing the pulmonary function of AIS patients in the orthopedic clinic setting.

Level of Evidence

Level II.

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Author information

Authors and Affiliations

  1. Children’s Orthopedic Center, Children’s Hospital Los Angeles, 4650 Sunset Blvd, 90027, Los Angeles, CA, USA

    Gabriela A. Villamor BA, Lindsay M. Andras MD, Priscella Chan MS, Joshua Yang BA & David L. Skaggs MD, MMM

  2. Seattle Children’s Hospital, 4800 Sand Point Way NE, 98105, Seattle, WA, USA

    Greg Redding MD

Authors
  1. Gabriela A. Villamor BA
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  2. Lindsay M. Andras MD
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  3. Greg Redding MD
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  4. Priscella Chan MS
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  5. Joshua Yang BA
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  6. David L. Skaggs MD, MMM
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Corresponding author

Correspondence to David L. Skaggs MD, MMM.

Additional information

Author disclosures: GAV (none), LMA (personal fees from Biomet, Zimmer, Medtronic, NuVasive, and Orthobullets; other from Eli Lilly, Journal of Pediatric Orthopedics, Pediatric Orthopaedic Society of North America, and Scoliosis Research Society, outside the submitted work), GR (other from Pediatric Pulmonology, outside the submitted work), PC (none), JY (none), DLS (grants from Pediatric Orthopaedic Society of North America and Scoliosis Research Society, paid to Columbia University, and Ellipse [co–principal investigator, paid to GSF]; personal fees from ZimmerBiomet, Medtronic, Zipline Medical, Inc., Orthobullets, Grand Rounds (a health care navigation company), Green Sun Medical, and Johnson & Johnson; nonfinancial support from Growing Spine Study Group, Scoliosis Research Society, Growing Spine Foundation; other from Zipline Medical, Inc., Green Sun Medical, Orthobullets, Medtronic, and ZimmerBiomet, Wolters Kluwer Health–Lippincott Williams & Wilkins; Biomet Spine, Orthobullets [co–editor in chief], outside the submitted work).

IRB approval: This study has been carried out with approval from the Institutional Review Board at Children’s Hospital Los Angeles.

Funding: None of the authors received financial support for this study.

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Villamor, G.A., Andras, L.M., Redding, G. et al. A Comparison of Maximal Voluntary Ventilation and Forced Vital Capacity in Adolescent Idiopathic Scoliosis Patients. Spine Deform 7, 729–733 (2019). https://doi.org/10.1016/j.jspd.2019.02.007

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  • DOI: https://doi.org/10.1016/j.jspd.2019.02.007

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