KYPHOSCOLIOSIS

KYPHOSCOLIOSIS
Kyphoscoliosis is a disorder characterized by progressive deformity of Spine consisting of lateral and posterior curvatures.
Clinical Picture
  • In majority it is of idiopathic etiology.
  • Deformity results in shortening of height.
  • Patients can be asymptomatic.
  • Mobility of chest wall is impaired, the chest wall is stiff and lung volumes are restricted.
  • Hypoventilation can occur due to small tidal volumes and increased dead space ventilation.
  • V/Q mismatch leads to significant hypoxia, and can progress to symptoms of Cor pulmonale.
  • CXR shows significant distortion of spine and thorax.
  • Mediastinal position is altered and tremendous regional variation in intensity of breath sounds can be noted on physical exam.
  • PFT will show a restrictive defect. Hypoxemia is common.
Therapy
  • Milwaukee brace controls moderate deformities.
  • Surgical correction is attempted in some to fix spine and arrest progression of the deformity.
  • Oxygen on long term may be necessary in patients with significant hypoxemia.


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