Correction of neuromuscular scoliosis in patients with preexisting respiratory failure

Spine (Phila Pa 1976). 2006 Oct 1;31(21):2478-83. doi: 10.1097/01.brs.0000239215.87174.8f.


Study design: A prospective observational study in scoliosis patients who were on noninvasive night ventilation for respiratory failure.

Objective: To report the results of spinal deformity correction in a group of patients with progressive scoliosis and rare forms of muscular dystrophy/myopathy with respiratory failure who were on nocturnal ventilatory support at the time of surgery.

Summary of background data: This is the first study on the results of deformity correction in a series of patients on ventilatory support.

Materials and methods: Eight patients (6 males, 2 females) presented with progressive scoliosis and respiratory failure. The mean age at surgery was 12 years (range, 8-15 years). The mean follow-up was 48 months (range, 12-80 months). Outcome measures include lung function (spirometry), overnight pulse oximetry, Cobb angles, duration of stay in Intensive care (ICU), and the total hospital stay.

Results: The mean stay in the ICU was 2.7 days (range, 2-5 days). The mean hospital stay was 14.2 days (range, 10-21 days). The mean preoperative Cobb angle was 70.2 degrees (55 degrees -85 degrees ). This changed to 32 degrees (16 degrees -65 degrees ) after surgery (P = 0.0002). The mean vital capacity at the time of surgery was 20% (range, 13%-28%). The mean vital capacity of patients at last follow-up was 18% (range, 10%-31%). The desaturation noted on the preventilation overnight oximetry was reversed by nocturnal ventilation. All patients recovered well following surgery with no major cardiac or pulmonary complications.

Conclusion: Patients with preexisting respiratory failure on nocturnal noninvasive ventilation can be safely operated for deformity correction. This can help to significantly improve their quality of life.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Female
  • Humans
  • Lumbar Vertebrae / surgery
  • Male
  • Muscular Dystrophies / physiopathology
  • Muscular Dystrophies / surgery
  • Neuromuscular Diseases / complications
  • Neuromuscular Diseases / physiopathology
  • Neuromuscular Diseases / surgery*
  • Prospective Studies
  • Respiration, Artificial / methods
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / surgery*
  • Scoliosis / complications
  • Scoliosis / physiopathology
  • Scoliosis / surgery*