Abstract
Background: Sniff nasal inspiratory pressure (SNIP) has become a valuable tool in assessing respiratory muscle weakness. Its role in the scoliosis population is still being defined.
Purpose: To assess significance of Sniff nasal inspiratory pressure value in paediatric patients with scoliosis.
Methods: Eighty-nine paediatric patients were investigated with SNIP at the time of preoperative assessment for scoliosis surgery from Jan, 2000 to Dec, 2006. Patients were divided into neuromuscular (24) and idiopathic (55). Other causes and revision were excluded (10). SNIP was evaluated with respect to curve pattern and curve degree. This included radiograph and case note review.
Results: The mean SNIP value for the idiopathic and neuromuscular groups was 70cmH2O and 44cmH2O respectively. This was statistically significantly different (0.006). The mean cobb angle for idiopathic pattern was 58 degree. For the neuromuscular group it was 73 degree. There was no correlation between SNIP value and curve severity in either the idiopathic or neuromuscular group.
Conclusion: SNIP is a valuable test when used in conjunction with vital capacity and overnight oxygen saturation, height, comorbidities in the neuromuscular population. It is a sensitive indicator of respiratory muscle weakness. It does not appear to reflect increasing curve severity. It does not appear relevant in scoliosis without a neuromuscular disorder.
Significance: SNIP combined with vital capacity, overnight oxygen saturation, height and co morbidities can be used to assess severity of neuromuscular scoliosis. SNIP value alone has little relevance.
Correspondence should be addressed to SBPR at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, England.
