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척추 후만증을 동반한 성인 척추결핵환자의 폐기능에 관한 연구 Pulmonary Function in Adults with Tuberculous Kyphosis of the Spine

대한정형외과학회지 1976년 11권 2호 p.225 ~ 231
성미숙, 구명회, 강현규,
소속 상세정보
성미숙 (  ) 
가톨릭대학교 의과대학 정형외과학교실

구명회 (  ) 
가톨릭대학교 의과대학 정형외과학교실
강현규 (  ) 
가톨릭대학교 의과대학 정형외과학교실

Abstract


Kyphosis and scoliosis develops from various causes. Tuberculosis is the main cause of kyphosis and spinal deformity in Korea. Such spinal deformities are frequently accompanied by cardiac and respiratory changes.
In 1969, Westgate and Moe reported that, when a kyphoscoliotic patient dies, he dies because of cardio-respiratory failure and not because of skeletal abnormality, and, in 1968 Nilsonne and Lundgren reported that the mortality in patients with severe spinal deformity was twice as high as in normal persons, and that heart or lung disease was the main cause of death. One must consider the cardiopulmonary status when treating patients with severe spinal deformities.
While there are numerous reports on pulmonary dysfunction due to scoliosis or kyphoscoliosis, studies on pulmonary function of patients with tuberculous kyphosis are surprisingly few.
The authors investigated the correlation of the degrees of curvature and pulmonary function on 17 cases of adults v~.ith tuberculous kyphosis and compared t´ie results with those of the children reported in 1972 by Moon and Lee.
The results of this study are as follows:
1. The over-all mean degree of kyphosis was 92.6´ (Salter´s angle). Vital .capacity was 63.1% and maximum breathing capacity 61.?% of the predicted; normal value.
2. Vital capacity showed a negative correlation with the degree of kyphotic curvature; i. e. the greater the spinal curvature, the less the vital capacity and vice versa; R=0.45, P=<0.1, but there was no correlation between maximum breathing capacity and the degree of curvature.
3. Vital capacity showed a relatively significant positive correlation with maximum breathing eapa4ity ~s kyphosis increased.
4. The over-all mean tidal volume increased 9.3 % of the normal predicted value.
5 When comparing with the pulmonary function of the children with same level and same degree of kyphosis, the adults had significant decrease in vital capacity and maximum breathing capacity, but had increased tidal volume. Such disparity was more prominent in the thoracic spine than in the lumbar spine and when the kyphotic curvature was greater than when less.
6. Timed vital capacity was within normal limits in spite of kyphotic changes of the spine.

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