Hu Zhengjun, Leng Yuanxian, Zhao Deng, Zhong Rui, Zhang Zhong, Jiang Dengxu, Wang Fei, Liang Yijian
Department of Orthopaedics, The Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
J Orthop Surg Res. 2025 Feb 28;20(1):213. doi: 10.1186/s13018-025-05630-5.
To investigate the risk factors for Type II respiratory failure associated with severe scoliosis in patients under 40 years of age.
Patients with severe scoliosis and pulmonary impairment treated in our hospital from January 2020 to December 2022 were recorded. We evaluated the spinal parameters in standing full spine X-rays, including the main thoracic curve, thoracic kyphosis, apical vertebrae, and distance between T1-T12. We also assessed the patient's pulmonary function test (PFT), including forced vital capacity (FVC) and the percentage of measured FVC values to predicted values (FVC%).
The study included 64 patients with severe and rigid scoliosis accompanied by severe pulmonary impairment. They were divided into two groups: Group 1 comprised 22 patients with Type II respiratory failure, and Group 2 comprised the remaining 42 patients without respiratory failure. The average age of onset for the two groups was 2.3 ± 2.9 years and 4.0 ± 4.5 years, respectively. The range of the apical vertebrae in Group 1 was from T6 to T11, and the range in Group 2 was the same. There was no significant difference in the main curve and kyphosis angle between the two groups. The average T1-T12 distances for the two groups were 130.3 ± 32.7 mm and 148.2 ± 37.6 mm, respectively. The PFT results indicated that all patients had severe pulmonary function impairment. Multivariate logistic regression analysis revealed that a T1-T12 distance of less than 100 mm was an independent risk factor for Type II respiratory failure.
If not treated properly, early onset scoliosis would have a severe impact on pulmonary function. The T1-T12 distance was a risk factor for Type II respiratory failure associated with severe scoliosis in patients under 40 years old.
探讨40岁以下严重脊柱侧弯患者发生Ⅱ型呼吸衰竭的危险因素。
记录2020年1月至2022年12月在我院接受治疗的严重脊柱侧弯和肺功能损害患者。我们在站立位全脊柱X线片上评估脊柱参数，包括主胸弯、胸椎后凸、顶椎以及T1-T12间距。我们还评估了患者的肺功能测试（PFT），包括用力肺活量（FVC）以及实测FVC值占预测值的百分比（FVC%）。
该研究纳入了64例伴有严重肺功能损害的严重僵硬性脊柱侧弯患者。他们被分为两组：第1组包括22例Ⅱ型呼吸衰竭患者，第2组包括其余42例无呼吸衰竭患者。两组的平均发病年龄分别为2.3±2.9岁和4.0±4.5岁。第1组顶椎范围为T6至T11，第2组范围相同。两组之间的主弯和后凸角度无显著差异。两组的平均T1-T12间距分别为130.3±32.7mm和148.2±37.6mm。肺功能测试结果表明所有患者均有严重的肺功能损害。多因素logistic回归分析显示，T1-T12间距小于100mm是Ⅱ型呼吸衰竭的独立危险因素。
如果治疗不当，早发性脊柱侧弯会对肺功能产生严重影响。T1-T12间距是40岁以下严重脊柱侧弯患者发生Ⅱ型呼吸衰竭的危险因素。
