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Impairments in pulmonary functions in paediatric spinal tuberculosis: a cross-sectional study

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Abstract

Purpose

This study aimed to investigate the impact of vertebral column destruction and kyphotic deformity due to spinal tuberculosis on pulmonary functions in paediatric patients.

Methods

A cross-sectional study was conducted, involving 30 patients diagnosed with healed spinal tuberculosis, aged 7–18 years. Detailed radiographic measurements, including the level of involvement, kyphosis angle, Spinal Deformity Index (SDI), and drug-resistance status, were compared with various pulmonary function parameters.

Results

The mean age of the study group was 12.8 ± 2.7 years (range 7–17 years), consisting of 11 males and 19 females. Fourteen patients were managed conservatively and 16 were managed operatively. The mean SDI was 5.2 ± 4.7. The mean kyphotic angle was 31.3° ± 25.3. The average number of involved vertebrae was 2.6 ± 1.5. Pulmonary functions were classified as restrictive in 24 patients, normal in 4 patients, obstructive in 1 patient, and mixed in 1 patient. Multidrug-resistant tuberculosis (MDR-TB) was detected in 5 (16.7%) patients, while the remaining 25 (83.3%) patients were sensitive to conventional antitubercular drugs. The correlation coefficients between the percentage reduction in forced vital capacity (FVC) and kyphosis angle, SDI, and number of vertebrae were 0.4 (p = 0.026), 0.4 (p = 0.028), and 0.19 (p = 0.295), respectively. The mean percentage reduction in FVC and total lung capacity (TLC) were 35.8 ± 15.7 and 6.2 ± 2.3, respectively. No significant association was observed between pulmonary functions and drug sensitivity status (p = 0.074).

Conclusions

Paediatric spinal tuberculosis can lead to thoracic insufficiency due to progressive destruction and shortening of the spinal column, spinal growth inhibition, and kyphotic deformity. Management of these cases should focus on promoting normal lung development while ensuring disease resolution and deformity correction. Further research should explore growth conserving or growth guiding systems to address or prevent growth retardation and simultaneously provide spinal stabilization.

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Funding

This research was funded by Indian Council of Medical Research MD/MS/DM/MCh/MDS Support [Reg No. MD20JUN-0141].

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Authors and Affiliations

  1. Department of Orthopedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, 400012, India

    Shivaprasad Sharangouda Kolur, Tushar Narayan Rathod, Rudra Mangesh Prabhu & Abhishek Kumar Rai

  2. Department of Radio-Diagnosis, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, 580022, India

    Maheshwari Basavangouda Patil

  3. Orthopedic Unit, Synapse Spine, Mumbai, Maharashtra, India

    Nandan Marathe

  4. Department of Paediatrics, Dr Shankarrao Chavan Govt Medical College, Nanded, Maharashtra, 431601, India

    Arvind Nilkanthrao Chavan

Authors
  1. Shivaprasad Sharangouda Kolur
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  2. Tushar Narayan Rathod
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  3. Maheshwari Basavangouda Patil
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  4. Rudra Mangesh Prabhu
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  5. Nandan Marathe
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  6. Abhishek Kumar Rai
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  7. Arvind Nilkanthrao Chavan
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Contributions

SSK conceptualization methodology, formal analysis and investigation, writing—original draft preparation, funding acquisition, resources. TNR conceptualization, methodology, formal analysis and investigation, writing—review and editing, supervision. MBP conceptualization, methodology, formal analysis and investigation, supervision. RMP conceptualization, writing—review and editing, supervision, funding acquisition. NM conceptualization, methodology, writing—review and editing, supervision. AKR methodology, writing—review and editing, supervision, resources. ANC conceptualization, methodology, writing—review and editing, supervision.

Corresponding author

Correspondence to Shivaprasad Sharangouda Kolur.

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Conflict of interest

All authors declare that there are no conflicts of interest.

Ethical approval

Institutional Ethics Committee approval was obtained for this study.

Consent for publication

Appropriate written informed consent has been taken from all the patients for inclusion in the study and publication process.

Informed consent

Informed consent and assent were taken from the legal guardians and patients for participation in the study and for publication of the data emerging from it.

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Kolur, S.S., Rathod, T.N., Patil, M.B. et al. Impairments in pulmonary functions in paediatric spinal tuberculosis: a cross-sectional study. Spine Deform 12, 199–207 (2024). https://doi.org/10.1007/s43390-023-00764-0

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  • DOI: https://doi.org/10.1007/s43390-023-00764-0

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