title: Can 'sniff nasal inspiratory pressure' determine severity of scoliosis in paediatric population?
abstract: BACKGROUND
  Sniff nasal inspiratory pressure (SNIP) has become a valuable tool in assessing respiratory muscle weakness. Its role in the scoliosis population is still being defined.
  
  
  OBJECTIVE
  To assess significance of SNIP value in paediatric patients with scoliosis.
  
  
  METHODS
  Eighty-nine paediatric patients were investigated with SNIP at the time of preoperative assessment for scoliosis surgery from January 2000 to December 2006. Patients were divided into neuromuscular (24) and idiopathic (55). Other causes and revision were excluded (10). SNIP was evaluated with respect to curve pattern and curve degree.
  
  
  RESULTS
  The mean SNIP value for the idiopathic and neuromuscular groups was 63 (+/-23) and 35 (+/-14) cmH(2)O, respectively. The mean Cobb angle for idiopathic and neuromuscular group was 58 (+/-18) and 67 (+/-16) degrees, respectively. Spearman's rank correlation coefficient showed no statistically significant correlation between SNIP value and curve degree. Chi-squared test showed a statistically significant association between SNIP and curve pattern (P = 0.006).
  
  
  CONCLUSIONS
  SNIP is a valuable test when used in conjunction with vital capacity and overnight oxygen saturation, height, comorbidities in the neuromuscular population. It is a sensitive indicator of respiratory muscle weakness. Low SNIP values are found in neuromuscular scoliosis in general. It does not appear to reflect increasing curve severity.
authors.affiliation: James Cook University Hospital, Middlesbrough, UK. manjuramappa@doctors.org.uk
authors.forename: Manjunath
authors.initials: M
authors.lastname: Ramappa
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology*; D008297:Male; D009468:Neuromuscular Diseases / Q000503:physiopathology*; D011312:Pressure; D012129:Respiratory Function Tests / Q000379:methods; D012132:Respiratory Muscles / Q000503:physiopathology; D012600:Scoliosis / Q000503:physiopathology*; D012720:Severity of Illness Index