Physical Medicine and Rehabilitation, Carlos Haya Hospital, Málaga, Spain.
Spine (Phila Pa 1976). 2013 Jun 1;38(13):E840-3. doi: 10.1097/BRS.0b013e31828f5419.
A case report.
To emphasize the importance of monitoring the breathing capacity in patients with moderate to severe scoliosis, even in adulthood.
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.
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).
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.
病例报告。
强调监测中重度脊柱侧凸患者呼吸能力的重要性，即使在成年后也是如此。
影响胸壁结构的疾病会影响呼吸泵的功能。严重的脊柱侧凸会导致限制性呼吸模式。然而，脊柱侧凸可能会由于气道受压而引起阻塞性变化。这种变化可能是由于椎体的压迫而直接导致，也可能是由于旋转力而间接导致。方法：我们从患者的临床病史中收集数据，并回顾了类似的已发表病例。
一名白人女性，儿童时期经常呼吸道感染。她被诊断为患有 55°右 T5-T11 脊柱侧凸。26 岁时，她出现了肺部症状加重的情况，表现为难以咳出黏液和中等用力呼吸困难。轴向计算机断层扫描显示 T8 椎体向右中间支气管施压。支气管镜检查发现支气管区域缩小，壁间几乎接触。肺功能检查：用力肺活量（FVC）41%，1 秒用力呼气量（FEV1）43%，FEV1/FVC1 为 91%。患者接受了使用棒和椎弓根螺钉进行的手术矫正；她的症状、影像检查和肺功能均得到改善（FVC 为 70%，FEV1 为 71%，FEV1/FVC1 为 101%）。
呼吸道感染的频率和严重程度增加、排痰困难和呼吸困难是气道受损的警告信号。肺功能检查和影像学检查（如轴向计算机断层扫描和支气管镜检查）对于诊断至关重要。手术方法可能是治疗的首选。
