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Pulmonary Function of Patients with Adolescent Idiopathic Scoliosis

Korean Journal of Pediatrics 2004;47(10):1076-1080.
Published online October 15, 2004.
Pulmonary Function of Patients with Adolescent Idiopathic Scoliosis
Yu Sok Han1, Hyun Ah Kim1, Uee Ryoung Chung2
1Department of Pediatrics, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
2Department of Spine Center, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
소아 척추 측만 환아의 폐환기 기능에 관한 연구
한유석1, 김현아1, 정의룡2
1인제대학교 의과대학 상계백병원 소아과
2인제대학교 의과대학 상계백병원 척추센터
Yu Sok Han, Email: yshan@dreamwiz.com
: To evaluate the patterns of preoperative pulmonary function tests(PFTs) and their correlation with postoperative pulmonary impairment in patients with adolescent idiopathic scoliosis(AIS), who had orthopaedic operation with or without rib resection thoracoplasty.
: The case records and radiographs of 79 patients(12, boys and 67, girls) of a mean age of 13.3 years(7-15 years) with AIS who underwent orthopaedic operations at the author's institute between 1997 and 2003 were reviewed.
: The average preoperative coronal Cobb measurement was 56 (range, 32-81 ). Thirty-one patients(39%) had normal values of of PFTs. Forty five patients(57%) with severe scoliosis(Cobb's angle 65-90 ) showed mild to moderate decrease on PFTs with FVC(73%), FEV1(79%), FEV25-75%(58 %). The severity of Cobb's angle were correlated with the decrease in FVC, FEV1, FEV25-75%(P< 0.05). Forty-three patients had thoracoplasty. Twenty-two(51%) of them had pleural effusions. Eleven patients among them had chest tube inserted postoperatively. But, none of the patients had any increased requirement of postoperative ventilatory support. The incidence of postoperative pulmonary effusion in patients with thoracoplasty was a 17-fold increase, compared to the patients without thoracoplasty(O.R.=17, χ2-test, P<0.05).
: The fall in FVC and FEV1 of patients with mild to moderate scoliosis(Cobb's angle, below 65 ) was mild and was unlikely to be of clinical significance. It appeared that patients with severe AIS had mild to moderate restrictive patterns with reduced lung volumes. Performance of the thoracoplasty was the important risk factor for postoperative pulmonary complications in patients underwent surgical operation.
Key Words: Adolescent idiopathic scoliosis, Pulmonary function test, Thoracoplasty, Pleural effusion

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