The risk factors for type ii respiratory failure in patients with severe scoliosis (less than 40-year old)

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.