Analysis of Clinical and Radiological Predictive Factors for Moderate and Severe Pulmonary Impairment in 102 Adolescent Idiopathic Scoliosis (AIS) Patients With Major Cobb Angle ≥45°: A Study of an Asian Population.

STUDY DESIGN

Retrospective cohort study.

OBJECTIVE

To investigate the independent predictive factors for moderate-severe pulmonary impairment (MSPI) among adolescent idiopathic scoliosis (AIS) patients.

METHODS

The preoperative pulmonary function tests (PFTs) of 102 AIS patients (°) operated between 2015 and 2020 were retrospectively reviewed. Patients were divided into 2 groups based on the predicted and , respectively. Group 1 had normal/ mild pulmonary impairment ( ) whereas Group 2 had MSPI ( . Multivariate logistic regression analysis was performed to determine the predictive factors for MSPI.

RESULTS

41.2% (N = 42) and 52.0% (N = 53) of the total patients were categorised into Group 2 (MSPI) based on predicted FVC and FEV, respectively. In general, Group 2 had more patients with a major main thoracic (MT) curve, larger MT curve with lower MT flexibility, a larger MT apical vertebra translation (MT-AVT), and a smaller thoracolumbar-lumbar (TL/L) AVT than Group 1 ( .). When analyzing the MT Cobb angle for every 10 increment, patients with MT Cobb angle ≥70° had MSPI (N = 31.4%). Body mass index (BMI) (FVC: aOR .8; FEV: aOR .9) and MT Cobb angle (, FVC: aOR 1.7; FEV: aOR 1.8) were the significant independent predictive factors for MSPI.

CONCLUSION

MSPI was evident in patients with MT Cobb angle ≥70°, with MT Cobb angle and BMI being the significant independent predictive factors.