Obstructive lung disease in children with idiopathic scoliosis

J Pediatr. 2015 Apr;166(4):1018-21. doi: 10.1016/j.jpeds.2014.12.070. Epub 2015 Feb 12.


Objective: To measure the prevalence of obstructive lung disease (OLD) among patients undergoing preoperative pulmonary assessment for idiopathic scoliosis.

Study design: This was a retrospective, descriptive review from clinical data in a tertiary care pediatric hospital in the US. Patients (n = 176) with idiopathic scoliosis with Cobb angles of ≥ 40 degrees who performed acceptable and repeatable preoperative pulmonary function testing were included. The primary outcome measure was the forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) ratio.

Results: The prevalence of OLD (low FEV1/FVC ratio) was 39% (68/176 patients). In multivariate modeling, radiographic measures were poor predictors of pulmonary function outcomes of FVC (r(2) 0.06), FEV1 (r(2) 0.05), FEV1/FVC ratio (r(2) 0.08), and total lung capacity (r(2) 0.06).

Conclusions: OLD is common in patients with idiopathic scoliosis. We recommend preoperative pulmonary function testing for patients with idiopathic scoliosis under consideration for spinal fusion surgery.

MeSH terms

  • Adolescent
  • Child
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Lung Diseases, Obstructive / epidemiology*
  • Lung Diseases, Obstructive / etiology
  • Lung Diseases, Obstructive / physiopathology
  • Male
  • Orthopedic Procedures / methods
  • Predictive Value of Tests
  • Preoperative Period
  • Prevalence
  • Prognosis
  • Respiratory Function Tests / methods*
  • Retrospective Studies
  • Risk Factors
  • Scoliosis / complications*
  • Scoliosis / epidemiology
  • Scoliosis / surgery
  • United States / epidemiology
  • Vital Capacity