title: Extrinsic bronchial obstruction caused by scoliosis.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  To emphasize the importance of monitoring the breathing capacity in patients with moderate to severe scoliosis, even in adulthood.
  
  
  BACKGROUND
  Diseases that disturb the structure of the chest wall affect the function of the respiratory pump. Restrictive respiratory pattern is caused by severe scoliosis. However, scoliosis may provoke obstructive changes due to compression of the airways. It can be a direct compression because of imprinting of vertebral bodies, or an indirect one, due to rotation forces. METHODS.: We have collected data from the patients' clinical history and have reviewed similar published cases.
  
  
  RESULTS
  
  
  
  METHODS
  a white female, with frequent respiratory tract infections during her childhood. She was diagnosed as having 55° right T5-T11 scoliosis. At age of 26, an increase of her pulmonary symptoms appeared with difficulty to expel mucus and medium efforts dyspnea. A computed axial tomographic scan showed T8 vertebral body pushing against the right intermediate bronchus. A bronchoscopy found a decrease in the bronchial area, with near contact between the walls. Lung function test: 41% forced vital capacity (FVC), 43% forced expiratory volume in 1 second (FEV1), and 91 FEV1/FVC1. The patient underwent surgical correction using rods and pedicle screws; she had improvement of symptoms, image tests, and pulmonary function (70% FVC, 71% FEV1, and 101 FEV1/FVC).
  
  
  CONCLUSIONS
  Increased frequency and severity of respiratory tract infections, difficulty in expelling mucus and dyspnea are warning signs of compromised airways. Spirometry tests and image tests such as computed axial tomography and bronchoscopy are essential for diagnosis. Surgical approach may be the treatment of choice.
authors: Physical Medicine and Rehabilitation, Carlos Haya Hospital, Málaga, Spain. irene_xd@hotmail.com
authors: Irene
authors: I
authors: de Torres García
authors: Pablo
authors: P
authors: de Cabo Moreno
authors: Ana M Godoy
authors: AM
authors: Ramírez
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology*; D001980:Bronchi / Q000473:pathology / Q000503:physiopathology; D001982:Bronchial Diseases / Q000209:etiology / Q000503:physiopathology*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D012129:Respiratory Function Tests; D012600:Scoliosis / Q000150:complications / Q000503:physiopathology*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed