title: Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients.
abstract: BACKGROUND
  This retrospective review aimed to examine the relationship between preoperative pulmonary function and the Cobb angle, location of apical vertebrae and age in adolescent idiopathic scoliosis (AIS). To our knowledge, there have been no detailed analyses of preoperative pulmonary function in relation to these three factors in AIS.
  
  
  METHODS
  A total of 38 patients with thoracic or thoracolumbar scoliosis were included. Curvature of spinal deformity was measured using the Cobb method. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used to evaluate preoperative pulmonary function. Statistical methods were used to analyse the relationship between preoperative pulmonary function and the factors that may contribute to poor pulmonary function.
  
  
  RESULTS
  The mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1-L3 than at T6-T8 or T9-T12 (p = 0.006).
  
  
  CONCLUSIONS
  Lung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients.
authors.affiliation: Department of Orthopaedics, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.|Department of Orthopaedics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.
authors.forename: Joehaimey
authors.initials: J
authors.lastname: Johari
authors.affiliation: Department of Orthopaedics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.|Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia, Pahang, Malaysia.
authors.forename: Mohd Ariff
authors.initials: MA
authors.lastname: Sharifudin
authors.affiliation: Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Azriani
authors.initials: A
authors.lastname: Ab Rahman
authors.affiliation: Department of Orthopaedics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.
authors.forename: Ahmad Sabri
authors.initials: AS
authors.lastname: Omar
authors.affiliation: Department of Orthopaedics, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.
authors.forename: Ahmad Tajudin
authors.initials: AT
authors.lastname: Abdullah
authors.affiliation: Department of Orthopaedics, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia.
authors.forename: Sobri
authors.initials: S
authors.lastname: Nor
authors.affiliation: Department of Orthopaedics, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia.
authors.forename: Weii Cheak
authors.initials: WC
authors.lastname: Lam
authors.affiliation: Department of Orthopedics, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
authors.forename: Mohd Imran
authors.initials: MI
authors.lastname: Yusof
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D007738:Kyphosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D008159:Lumbar Vertebrae; D008168:Lung / Q000503:physiopathology*; D008297:Male; D057234:Preoperative Period; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012600:Scoliosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae; D055815:Young Adult
keywords: apical vertebra; cobb angle; idiopathic scoliosis; pulmonary function; spinal deformity
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