A Study On The Characteristics Of Lung Function Impairment In Adolescents With Chiari Malformation And Scoliosis, And A Study On Imaging And Clinical Outcomes Of Adolescents With Lumbar Disc Herniation And Sciatic Scoliosis

ObjectiveTo compare the pulmonary function between adolescent patients with Chiari malformation associated scoliosis?CMS?and adolescent idiopathic scoliosis?AIS?.Methods A retrospective analysis was performed on 52 patients with CMS,and 52patients with AIS were selected as the control group matched age,sex,and Cobb angle.Preoperative pulmonary function tests were completed by all patients,including vital capacity?VC?,forced vital capacity?FVC?,forced expiratory volume in one second?FEV₁?,maximal mid-expiratory flow?MMEF?,and ratio of FEV₁ to FVC.The difference of pulmonary function parameters was analyzed in two groups;Correlation between pulmonary function and radiographic parameters was analyzed in patients with CMS.ResultsThere were no significant differences in terms ofsex,age,and the main coronal Cobb angle between two groups.There are 42?81%?and 44?85%?of patients with restrictive ventilatory dysfunction?the percentage of predicted FVC<80%?in CMS and AIS group respectively.18?42.8%?and 10?22.7%?of them with obstructive ventilation dysfunction?FEV₁/FVC<92%?in CMS and AIS group respectively.Types of ventilation dysfunction distributed between the two groups had no significant difference?P>0.05?.No significant difference was noted between two groups in the percentage of predicted VC,FVC,FEV₁ and FEV₁/FVC?P>0.05?.The percentage of predicted MMEF in patients with CMS was lower compared to those with AIS?57.9±13.3 vs 67.2±23.3,P=0.053?.In patients with CMS,the percentage of predicted VC,FVC and FEV₁ had significant negative correlation with the number of vertebrae involved?P<0.01?;Main coronal Cobb angle had negative correlation with the percentage of predicted VC,FVC and FEV₁?P<0.05?;The percentage of predictedVC,FVCandFEV₁ hadpositivecorrelationwiththoracic kyphosis?P<0.05?.ConclusionsThere are no significant differences on characteristics of the pulmonary dysfunction between patients with AIS and CMS without obvious neural deficit.Both groups mainly present as restrictive ventilation dysfunction.Objectives: To compare the radiological features of scoliosis secondary to lumbar disc herniation?LDH?between adolescents and adults,and to further characterize the curve evolution after lumbar discectomy in two cohorts.Methods: Patients with scoliosis secondary to LDH who underwent surgical intervention between 2010 and 2016 were reviewed.Radiographic parameters were measured on standing whole spine radiographs.The apical vertebral translation was measured on serial radiographs taken before surgery,one,six months after surgery,and at last follow-up to evaluate the curve evolution.Meanwhile the patients-reported outcomes were evaluated.According to the age,patients were divided into adolescent and adult group.Comparisons between the two groups were made with regards to the preoperative,postoperative radiographic parameters and clinical outcomes.Results: A total of 42 adolescent and 41 adult patients were included in this study.The incidence of scoliosis secondary to LDH in the adolescents was significantly higher than that in the adults.Adolescent Patients present remarkably higher incidence of coronal balance as compared to the adult Patients preoperatively.No significant difference was observed between the two groups in terms of preoperative radiographic parameters.85.7% of the adolescent patients and 92.7% of the adult patients achieved resolution of scoliosis within 6 months after surgery.Conclusions: The incidence of scoliosis secondary to LDH in adolescents is significantly higher than in adults.Moreover,adolescent patients are more likely to present coronal balance before surgery.The two cohorts could have comparable curve evolution,and resolution of scoliosis generally occurred within 6 months after surgery.