Correlation of Spine Deformity, Lung Function, and Seat Pressure in Spina Bifida.
Summary of "Correlation of Spine Deformity, Lung Function, and Seat Pressure in Spina Bifida."
Spinal deformity, a common problem in children with myelodysplasia, is associated with alterations in pulmonary function and sitting balance. Sitting imbalance causes areas of high pressure in patients already at high risk for developing pressure ulcers due to insensate skin. QUESTIONS/
We asked: Does spinal deformity affect pulmonary function tests in children with myelodysplasia? Does the magnitude of spinal curvatures and pelvic obliquity affect seating pressures? Does spinal deformity and seated pressures correlate with a history of pressure ulcers? PATIENTS AND
We retrospectively reviewed 32 patients with myelodysplasia and scoliosis (mean age, 14 years). The mean thoracic scoliosis was 64° with a mean pelvic obliquity of 15°. The mean forced vital capacity was 59% of predicted. The mean of the average and peak seated pressures were 24 and 137 mm Hg, respectively. We examined spinal radiographs, pulmonary function tests, and seated pressure maps and evaluated correlations of spinal deformity measures, pulmonary function, and seated pressures.
The thoracic scoliosis inversely correlated with lung volume and weakly related with only the forced midexpiratory volume parameter (R(2) = 31%). The curve magnitude was associated with % seated area with pressures of 38 to 70 mm Hg while lesser degrees of pelvic obliquity were associated with % seating area with pressures of less than 38 mm Hg (R(2) = 25% and 24%, respectively). A history of pressure ulcers did not correlate with any spinal deformity or seated pressure measures.
All patients displayed a reduced forced vital capacity, but this reduction was not related to increasing scoliosis. The smaller scoliosis curves and lesser degrees of pelvic obliquity were associated with larger areas of low seated pressures.
Department of Orthopaedic Surgery, University of Kentucky, Lexington, KY, USA.
This article was published in the following journal.
Name: Clinical orthopaedics and related research
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21125362
- DOI: http://dx.doi.org/10.1007/s11999-010-1687-8
Medical and Biotech [MESH] Definitions
The capability of the LUNGS to distend under pressure as measured by pulmonary volume change per unit pressure change. While not a complete description of the pressure-volume properties of the lung, it is nevertheless useful in practice as a measure of the comparative stiffness of the lung. (From Best & Taylor's Physiological Basis of Medical Practice, 12th ed, p562)
Deformities of the SPINE characterized by an exaggerated convexity of the vertebral column. The forward bending of the thoracic region usually is more than 40 degrees. This deformity sometimes is called round back or hunchback.
Restraining belts fastened to the frame of automobiles, aircraft, or other vehicles, and strapped around the person occupying the seat in the car or plane, intended to prevent the person from being thrown forward or out of the vehicle in case of sudden deceleration.
Congenital defects of closure of one or more vertebral arches, which may be associated with malformations of the spinal cord, nerve roots, congenital fibrous bands, lipomas, and congenital cysts. These malformations range from mild (e.g., SPINA BIFIDA OCCULTA) to severe, including rachischisis where there is complete failure of neural tube and spinal cord fusion, resulting in exposure of the spinal cord at the surface. Spinal dysraphism includes all forms of spina bifida. The open form is called SPINA BIFIDA CYSTICA and the closed form is SPINA BIFIDA OCCULTA. (From Joynt, Clinical Neurology, 1992, Ch55, p34)
A developmental deformity of the occipital bone and upper end of the cervical spine, in which the latter appears to have pushed the floor of the occipital bone upward. (Dorland, 27th ed)
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