Scoliosis and the respiratory system

Scoliosis is caused by the lateral displacement and rotation of the vertebral bodies. It is most common during periods of rapid somatic growth. Scoliosis impedes on the movement of the ribs, places the respiratory muscles at a mechanical disadvantage and displaces the various organs of the thoracic cavity. Scoliosis decreases the chest wall compliance directly and the lung compliance indirectly (due to progressive atelectasis and air-trapping), causing a significant increase in the work of breathing that, because of the associated respiratory muscle weakness may lead to chronic respiratory failure. Progressive pulmonary hypertension also constitutes a leading cause for morbidity and mortality. Scoliosis is not reversible, but it can be controlled. Routine screening should start early and continue until the child reaches skeletal maturation. Pulmonary function testing can provide an easy and reliable means for the evaluation and follow-up of the condition. (C) 2006 Elsevier Ltd. All rights reserved.