Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation
Introduction Despite a significant advancement in operative techniques of occipitocervical fixation, there is a poor postoperative patient outcome. This can be attributed to restrictive lung pattern in craniovertebral junction anomalies (CVJAs) patients resulting from repeated trauma to cervicomedul...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2020-06-01
|
| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1712064 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849739596120719360 |
|---|---|
| author | Shaam Bodeliwala Vikas Nagar Hukum Singh Daljit Singh Anita Jagetia Sharad Pandey Rajesh Ruttala Pankaj Kumar |
| author_facet | Shaam Bodeliwala Vikas Nagar Hukum Singh Daljit Singh Anita Jagetia Sharad Pandey Rajesh Ruttala Pankaj Kumar |
| author_sort | Shaam Bodeliwala |
| collection | DOAJ |
| description | Introduction Despite a significant advancement in operative techniques of occipitocervical fixation, there is a poor postoperative patient outcome. This can be attributed to restrictive lung pattern in craniovertebral junction anomalies (CVJAs) patients resulting from repeated trauma to cervicomedullary junction by the pincer action of the bony anomalies and compression of the brainstem. We evaluate the changes in pulmonary function tests (PFTs) following rigid occipitocervical fixation in CVJA.
Methods PFTs of 20 CVJA patients were measured pre and postoperatively using spirometry. Measurements included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum forced mid-expiratory flow rate (FEF25–75%), and ratio of FEV1 and FVC (FEV1%). The parameters were compared with the predicted normal values based on their age and sex. PFTs were repeated on the seventh postoperative day. McCormick grading was used to assess neurological function.
Results The values of PFTs in the preoperative period were significantly lower than predicted normal values. The mean values of FVC, FEV1, FEF25–75% were 72, 68, and 71% of their mean predicted values, with FEV1% in the range of 70 to 95% with a mean of 81.4%. Postoperatively there was further significant reduction in the mean values of FVC, FEV1, FEF25–75%, and FEV1% compared with the preoperative values. There was neurological improvement in McCormick grades of patients postoperatively (from grade III and IV to grade II).
Conclusion A significant restrictive lung disease is present in patients of CVJA, even though not clinically apparent, and it persists in the early postoperative period. However, a long-term follow-up is required to assess whether pulmonary function parameters improve subsequently. |
| format | Article |
| id | doaj-art-f1580fdecfff46e09be6c2ccc44c8d43 |
| institution | DOAJ |
| issn | 2277-954X 2277-9167 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj-art-f1580fdecfff46e09be6c2ccc44c8d432025-08-20T03:06:14ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672020-06-0190315716110.1055/s-0040-1712064Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical FixationShaam Bodeliwala0Vikas Nagar1Hukum Singh2Daljit Singh3Anita Jagetia4Sharad Pandey5Rajesh Ruttala6Pankaj Kumar7Department of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, Delhi, IndiaDepartment of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, Delhi, IndiaDepartment of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, Delhi, IndiaDepartment of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, Delhi, IndiaDepartment of Neurosurgery, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research (GIPMER), New Delhi, Delhi, IndiaDepartment of Neurosurgery, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, Delhi, IndiaDepartment of Medicine, Maulana Azad Medical College, New Delhi, Delhi, IndiaDepartment of Neurosurgery, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, Delhi, IndiaIntroduction Despite a significant advancement in operative techniques of occipitocervical fixation, there is a poor postoperative patient outcome. This can be attributed to restrictive lung pattern in craniovertebral junction anomalies (CVJAs) patients resulting from repeated trauma to cervicomedullary junction by the pincer action of the bony anomalies and compression of the brainstem. We evaluate the changes in pulmonary function tests (PFTs) following rigid occipitocervical fixation in CVJA. Methods PFTs of 20 CVJA patients were measured pre and postoperatively using spirometry. Measurements included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum forced mid-expiratory flow rate (FEF25–75%), and ratio of FEV1 and FVC (FEV1%). The parameters were compared with the predicted normal values based on their age and sex. PFTs were repeated on the seventh postoperative day. McCormick grading was used to assess neurological function. Results The values of PFTs in the preoperative period were significantly lower than predicted normal values. The mean values of FVC, FEV1, FEF25–75% were 72, 68, and 71% of their mean predicted values, with FEV1% in the range of 70 to 95% with a mean of 81.4%. Postoperatively there was further significant reduction in the mean values of FVC, FEV1, FEF25–75%, and FEV1% compared with the preoperative values. There was neurological improvement in McCormick grades of patients postoperatively (from grade III and IV to grade II). Conclusion A significant restrictive lung disease is present in patients of CVJA, even though not clinically apparent, and it persists in the early postoperative period. However, a long-term follow-up is required to assess whether pulmonary function parameters improve subsequently.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1712064craniovertebral junction anomaliesrigid occipitocervical fixationpulmonary function test |
| spellingShingle | Shaam Bodeliwala Vikas Nagar Hukum Singh Daljit Singh Anita Jagetia Sharad Pandey Rajesh Ruttala Pankaj Kumar Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation Indian Journal of Neurosurgery craniovertebral junction anomalies rigid occipitocervical fixation pulmonary function test |
| title | Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation |
| title_full | Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation |
| title_fullStr | Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation |
| title_full_unstemmed | Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation |
| title_short | Pattern of Pulmonary Dysfunctions in Craniovertebral Junction Anomaly and Its Persistence after Rigid Occipitocervical Fixation |
| title_sort | pattern of pulmonary dysfunctions in craniovertebral junction anomaly and its persistence after rigid occipitocervical fixation |
| topic | craniovertebral junction anomalies rigid occipitocervical fixation pulmonary function test |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1712064 |
| work_keys_str_mv | AT shaambodeliwala patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT vikasnagar patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT hukumsingh patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT daljitsingh patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT anitajagetia patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT sharadpandey patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT rajeshruttala patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation AT pankajkumar patternofpulmonarydysfunctionsincraniovertebraljunctionanomalyanditspersistenceafterrigidoccipitocervicalfixation |