Scoliosis and Cor Pulmonale

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Abstract
Patients (20) with cor pulmonale due to scoliosis and associated spine deformities seen at the Twin Cities Scoliosis Center [Minnesota, USA] in the past 20 yr have been reviewed. The average age was 37 yr. The average scoliosis was 135.degree. and ranged from 90.degree. to 200.degree.. Patients (15) were placed in halo traction, 9 of whom went on to surgical stabilization. Of the 9 patients having surgical treatment, 5 had postpoliomyelitis curves, 2 had congenital, 1 had infantile idiopathic, and 1 had frontometaphyseal dysplasia. The best results were in the postpoliomyelitis group, with an average pretreatment vital capacity of 595 cm3 and posttreatment vital capacity of 1071 cm3; the average PaO2 increased from 55 to 64 mm Hg, and the average PaCO2 decreased from 52 to 43 mm Hg. The only death in the postpoliomyelitis group occurred 6 yr postoperatively. Of the 4 nonpoliomyelitis patients having surgery, only 1 survived, the patient with frontometaphyseal dysplasia. The difference between the poliomyelitis and nonpoliomyelitis groups was striking. Patients with cor pulmonate due to spine deformity should have careful evaluation and a trial of halo traction. If the vital capacity improves, the PaO2 increases, and the PaCO2 decreases, then surgical stabilization can often be successfully accomplished. If these parameters do not improve in traction, then surgical treatment can be abandoned.

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