At what Cobb angle does respiratory compromise occur in scoliosis?

Respiratory compromise in patients with scoliosis typically becomes significant when the Cobb angle is greater than 60 degrees. At this angle, the structural deformity of the spine begins to severely affect chest wall mechanics and lung capacity.

Specifically, as the severity of the scoliosis increases, the deformity can lead to thoracic cavity distortion, which can impair the ability of the lungs to expand fully during inhalation. As a result, individuals may experience decreased functional residual capacity and vital capacity. Symptoms of respiratory compromise might manifest as diminished exercise tolerance, shortness of breath, and decreased overall physical functional capacity.

While mild scoliosis (generally angles less than 20 degrees) typically does not lead to significant pulmonary compromise, and progressive angles from 20 to 45 degrees might start to have mild effects on respiratory function, it is not until the curvature exceeds 60 degrees that the majority of individuals will experience substantial respiratory limitations. Thus, the correct understanding of when respiratory compromise significantly occurs correlates with the increase in Cobb angles, emphasizing the importance of careful monitoring and potential interventions as scoliosis progresses.