Its diagnosis can be made after exclusion of a primary etiology such as vertebral anomaly, neuromuscular disorder, Marfan syndrome or other disorder. Idiopathic scoliosis is further categorized as infantile, juvenile and adolescent, according to the age at which the spinal deformity is first noticed. Based on population studies it is considered a single-gene disease with variable penetrance and heterogeneity. Idiopathic scoliosis accounts for approximately 85% of cases and it is defined as a structural scoliosis for which no specific cause can be established. It can be congenital, due to vertebral or rib malformation, secondary to a variety of systemic or neuromuscular disorders, or idiopathic. It is the result of a pathologic process which leads to lateral curvature of the spine. Scoliosis is the most common 3-dimensional deformation abnormality of the spine with direct effects on the thoracic cage, with a reported prevalence in the general population varying significantly from 0.3% to 15.3%. Preoperative pulmonary function testing required, as well as the effects of various surgical approaches on respiratory function are also discussed. In this review the epidemiological and anatomical aspects of idiopathic scoliosis are noted, the pathophysiology and effects of idiopathic scoliosis on respiratory function are described, the pulmonary function testing including lung volumes, respiratory flow rates and airway resistance, chest wall movements, regional ventilation and perfusion, blood gases, response to exercise and sleep studies are presented. Pulmonary hypertension and respiratory failure may develop in severe disease. Scoliosis decreases the chest wall as well as the lung compliance and results in increased work of breathing at rest, during exercise and sleep. Scoliosis results in a restrictive lung disease with a multifactorial decrease in lung volumes, displaces the intrathoracic organs, impedes on the movement of ribs and affects the mechanics of the respiratory muscles. Idiopathic scoliosis, a common disorder of lateral displacement and rotation of vertebral bodies during periods of rapid somatic growth, has many effects on respiratory function.
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