Relationship between pulmonary function and the degree of spinal deformity among adolescent idiopathic scoliosis (AIS) patients

Background: A retrospective record review was conducted among patients aged between 13 to 24 years, diagnosed as adolescent idiopathic scoliosis (AIS) and admitted at Hospital Raja Perempuan Zainab II for surgical intervention from year 2000 to 2013. Methodology: The spinal deformity curvatu...

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Bibliographic Details
Main Authors: Johari, Joehaimey, Nor, Sobri, Lam, Andrew, Omar, Ahmad Sabri, Abdullah, Ahmad Tajudin, Ab Rahman, Azriani, Sharifudin, Mohd Ariff, Yusof, Mohd Imran
Format: Conference or Workshop Item
Language:English
English
Published: 2013
Subjects:
Online Access:http://irep.iium.edu.my/32603/
http://irep.iium.edu.my/32603/
http://irep.iium.edu.my/32603/1/Kelantan_Research_Day_2013_-_Scoliosis_%28Slides_Presentation%29.pdf
http://irep.iium.edu.my/32603/14/Kelantan_Research_Day_2013.pdf
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Summary:Background: A retrospective record review was conducted among patients aged between 13 to 24 years, diagnosed as adolescent idiopathic scoliosis (AIS) and admitted at Hospital Raja Perempuan Zainab II for surgical intervention from year 2000 to 2013. Methodology: The spinal deformity curvature was measured by the Cobb method on anterior-posterior radiographs. The forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1) were used to evaluate the pre operative pulmonary function. Simple linear regression was performed to analyse the relationship between Cobb angle and pre operative pulmonary function. Kruskal-Wallis and Mann Whitney tests were used to compare the lung function according to different levels of affected spinal vertebrae and the severity of the deformity. Results: Thirty-eight patients were recruited for the study; 18 patients of Lenke type IA, 13 patients of type IB and 7 patients of type V. The mean age of patients was 16.7 years (SD=6.04). Although statistically insignificant, results indicated inverse relationships between Cobb angle with FVC (b=-0.319; 95% CI B=-0.647, 0.009), and FEV1 (b=-0.326; 95% CI B=-0.683, 0.030). The median FVC was significantly higher in those with affected apical vertebrae at L1, L2, and L3 levels (median=92; IQR=30) than those with apical vertebrae at T6, T7, and T8 (median=68.5; IQR= 36) (p=0.008). The median FVC was also significantly higher in those with affected apical vertebrae located at L1, L2, and L3 (median =92; IQR =30) than those with affected T9 to T12 (median =74; IQR=19) (p=0.003). The median FVC was higher among those who have lower end vertebrae involving L1, L2, and L3 (median=83.5; IQR=19) than those with lower end vertebra involving T6 to T12 (median=70.5; IQR=31) (p=0.014). Conclusion: The lung function impairment was seen in more severe spinal deformity, more proximally located curve and in patients that are more elderly.