Authors: Gregory J Redding Oscar H Mayer
Publish Date: 2010/10/27
Volume: 469, Issue: 5, Pages: 1330-1334
Abstract
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 earlyonset scoliosis EOSWe 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 lungsWe 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 anglesIn 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 18 to 115 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 postoperativelyThe 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 functionEach author certifies that his or her institution approved the human protocol for this investigation that all investigations were conducted in conformity with ethical principles of research and that informed consent for participation in the study was obtained
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