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Vol. 26. Issue 3.
Pages 98-102 (April 1990)
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Vol. 26. Issue 3.
Pages 98-102 (April 1990)
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Escoliosis idiopática. función respiratoria antes y después de su corrección quirúrgica. Evolución al término de un año
Idiopathic scoliosis. Respiratory function before and after surgical correction. One year evolution.
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A. De Diego, P. Morales, V. Macian, M. Palau, V. Marco
Servicio de Neumología, Hospital la Fe. Valencia
J.L. Bas*
* Servicio de Ortopedia. Hospital la Fe. Valencia
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La escoliosis, cuando es importante, suele acompañarse de un deterioro de la función respiratoria. Su corrección quirúrgica, si bien reduce el grado de deformidad osteomuscular, muestra unos resultados muy variables sobre la función respiratoria.

En nuestro estudio hemos analizado la relación entre el grado de escoliosis, determinado por el ángulo de Cobb, y las posibles alteraciones en la exploración funcional respiratoria, así como las modificaciones producidas un año después de su corrección quirúrgica, por el método de Harrington.

Estudiamos 25 pacientes de ambos sexos, de edad media 19 años, con escoliosis idiopática (ángulo de Cobb: 64°±28°) y sin otra patología respiratoria. Los resultados preoperatorios de la función pulmonar, expresados como porcentajes del valor teórico y como x±DE, fueron: FVC (78±19%), RV (75±23%), TLC (80±16%), FRC (79±22%), FEV1 (81±15%), sDLCOSB (89±19%), sGAW (0,151±0,050 cm H2O-1s-1), PI max (77±20 cm H2O). PaO2 (93±8 mmHg), Pa CO2 (32±3 mmHg) y P(A-a)O2 (22±8 mmHg). La correlación del grado de deterioro funcional con el ángulo de Cobb, únicamente fue significativa para la FVC, FEV1 y PaO2.

Al año de la intervención, el ángulo de Cobb disminuyó significativamente (39°±19°), observándose sólo una mejoría significativa en el intercambio gaseoso (PaO2 98±4 mmHg y P(A-a)O2 16±4 mmHg).

Al analizar los resultados, observamos que esta mejoría se producía principalmente a expensas de los pacientes con ángulo de Cobb > 55°, mientras que aquellos con ángulo de Cobb < 55°, no sólo no mejoraban la función respiratoria sino que tampoco disminuía significativamente el grado de deformidad.

When scoliosis is significant it is usually associated with an impairment of respiratory function. Altrough surgical therapy reduces the degree of neuromuscular deformity, its results on respiratory function are very variable.

In the present study we evaluated the relation between the degree of scoliosis, measured, by Cobb's angle, the possible abnormalities in respiratory functional test and their change one after surgical correction with Harrington's technique. We investigated 25 patients, both males and females (mean age 19 years), with idiopathic scoliosis (Cobb's angle 64°±28°) and no other respiratory disease. The preoperative results of pulmonary function test were as follows, given as percentages of the predicted value and as X±SD: FVC (78±19%), RV (75±23%), TLC (80±16%), FRC (79±22%), FVE1 (81±15%), sDLCOSB (89±19%), sGAW (0,151±0,50 cm H2O-1s-1), Px max (77±20 cm H2O), PaO2 (93±8 mmHg), PaCO2 (32±3 mmHg) and P(A-a)22±8 mmHg). The correlation of functional impairment with Cobb's angle was significant only for FVC, FEV1 and PaO1. One year after operation, Cobb's angle was significantly redu-ced (39°±19°), a significant improvement being only found for gas exchange (PaO2 98±4 mmHg and P(A-a)O2 16±4 mmHg).

In the analysis of the results we found that this improvement was achived mainly in patients with Cobb's angle > 55°, while in those in witch in which it was < 55° no only respiratory function did not improve but also the deformity degree was not significantly reduced.

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Bibliografía
[1.]
H.E. Bergofsky.
Thoracic Deformities.
The Thorax. Lung biology in health and disease, pp. 941
[2.]
H.E. Bergofsky.
Respiratory failure in disorders of the thoracic cage.
State of the Art. Am Rev Respir Dis, 119 (1979), pp. 643-669
[3.]
R.E. Kafer.
Respiratory and cardiovascular functions in scolio sis.
Bull Europ Phys Resp, 13 (1977),
[4.]
B. Weber, J.P. Smyth, W.A. Briscoe, S.A. Friedmann, T.K.C. King.
Pulmonary function in asymptomatic adolescents with idiopathic scoliosis.
Am Rev Respir Dis, 111 (1975), pp. 389-397
[5.]
R.J. Smyth, K.R. Champmann, T.A. Wright, J.S. Crawford, A.S. Rebuck.
Pulmonary function in adolescents with mild idiopathic scoliosis.
Thorax, 39 (1984), pp. 901-904
[6.]
C. Lisboa, R. Moreno, M. Fava, R. Ferreti, E. Cruz.
Inspiratory muscle function in patients with severe kyphoscoliosis.
Am Rev Respir Dis, 132 (1985), pp. 48-52
[7.]
R.S. Jones, J.D. Kannedy, F. Hashman, R. Owen, J.F. Taylor.
Mechanical inefficiency of the thoracic cage in scoliosis.
Thorax, 36 (1981), pp. 456-461
[8.]
E.H. Sawicka, H.A. Branthwaite.
Respiration during sleep in kyphoscoliosis.
Thorax, 42 (1987), pp. 801-808
[9.]
E.R. Kafer.
Idiopatic scoliosis, gas exchange and the age depen dence of arterial blood gases.
J Clin Invest, 58 (1976), pp. 825-833
[10.]
P.R. Harrington.
Treatment of scoliosis. Correction and inter nal fixation by spine instrumentation.
J Bone Jt Surg, A–44 (1962), pp. 591-610
[11.]
J.R. Cobb.
Outline for the study of scoliosis: Instruccional course lectures.
Am Acad Orthop Sutg, 5 (1948), pp. 261-275
[12.]
J. BJure, G. Grimby, A. Nachemson.
Correction of body height in predicting spirometric values in scoliotic patients.
Scand J Clin Invest, 21 (1968), pp. 184-192
[13.]
K. Linderholm, V. Lindgren.
Prediction of spirometric values in patients with scoliosis.
Acta Orthop Scand, 49 (1978), pp. 469-474
[14.]
Normativa para la espirometría forzada.
Recomendaciones SEPAR.
Ed. Doyma, (1985),
[15.]
H.I. Goldman, M.R. Becklake.
Respiratory function tests.
Normal values at median altitudes and the prediction of normal results. Am Rev Tuberc, 79 (1959), pp. 457-467
[16.]
J.F. Morris, A. Kosky, L.C. Johnson.
Spirometric standards for healthy nonsmoking adults.
Am Rev Respir Dis, 103 (1971), pp. 57-67
[17.]
W.A. Briscoe, A.B. Du Bois.
The relationship between airway resistance and lung volume in subjects of different age and body size.
J Clin Invest, 32 (1958), pp. 1279-1285
[18.]
J.E. Cortes.
. Lung function.
4 th. ed, Blackwell Scienti fic Publications, (1979),
[19.]
J.M. Raine, J.M. Bishop.
A-a difference in 02 tension and physiological dead space in normal man.
J Appl Physiol, 18 (1963), pp. 284-288
[20.]
L.F. Black, R.E. Hyatt.
Maximal respiratory pressures: normal values and relationship to age and sex.
Am Rev Respir Dis, 99 (1969), pp. 696-702
[21.]
H.C. Olsen, J.C. Gibson.
Respiratory symptoms, bronchitis and ventilatory capacity in man.
Br Med J, 1 (1960), pp. 450-456
[22.]
C.G. Caro, A.B. Du Bois.
Pulmonary function in kyphoscoliosis.
Thorax, 16 (1961), pp. 282-290
[23.]
M. Ramonatxo, J. Millic-Emili, C. Prefaut.
Breathing pattern and load compensatory responses in young scoliotic patients.
Eur Respir J, 1 (1988), pp. 421-427
[24.]
D.C. Shannon, E.J. Riseborough, L.M. Valencia, H. Kazemi.
The distribution of abnormal lung function in kyphoscoliosis.
J Bone Jt Surg, A–52 (1970), pp. 131-143
[25.]
B. Bake, J. Bjure, J. Kasalicky, A. Nachemson.
Regional pulmonary ventilation and perfusion distribution in patients with untrea ted idiopatic scoliosis.
Thorax, 27 (1972), pp. 703-712
[26.]
J. Bjure, G. Grimby, J. Kasalicky, H. Lindh, A. Nachemson.
Respiratory impairment and airway closure in patients with untrea ted idiopathic scoliosis.
Thorax, 25 (1970), pp. 451-456
[27.]
D.M. Cooper, J. Velasquez, R. Mellins, H. Keim, A. Mansell.
Respiratory mechanics in adolescents with idiopathic scoliosis.
Am Rev Respir Dis, 130 (1984), pp. 16-22
[28.]
J.M. Shneerson, A.M. Edgar.
Cardiac and respiratory function before and after spinal fusion in adolescent idiopathic scoliosis.
Thorax, 34 (1979), pp. 658-661
[29.]
K. Kumano, N. Tsuyama.
Pulmonary function before and after surgical Correction of scoliosis.
J Bone Jt Surg, A–64 (1982), pp. 242-248
[30.]
M. Lindh, J. Bjure.
Lung volumes in scoliosis before and after Correction by the Harrington instrumentation method.
Acta Orthop Scand, 46 (1975), pp. 934-948
[31.]
H.D. Westgate, J.H. Moe.
Pulmonary function in kyphoscoliosis before and after correction by the Harrington instrumentation method.
J Bone Jt Surg, 51 (1969), pp. 935-946
Copyright © 1990. Sociedad Española de Neumología y Cirugía Torácica
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