19 Harley St, London, W1G 9QJ, UK

Maximal pulmonary recovery after spinal fusion for adolescent idiopathic scoliosis: how do anterior approaches compare?

STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To compare the relative rates of pulmonary recovery and maximal pulmonary function with surgical approach. SUMMARY OF BACKGROUND DATA: Anterior versus posterior spinal fusion (ASF, PSF) for the treatment of adolescent idiopathic scoliosis (AIS) has been debated. Although procedures that violate the chest wall may compromise pulmonary function, lung function continues to improve after surgery at variable rates depending upon surgical approach. METHODS: We reviewed the medical records from one hundred fifty nine AIS patients (age 15.6+/-2.2; 113 women; 46 men) treated with spinal fusion from 2003 to 2007 by a single surgeon. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and radiographic measurements were evaluated before surgery and at 1, 3, 6, 12, and 24-months follow-up on average. Four surgical groups were compared: PSF, ASF (open thoracoabdominal approach for thoracolumbar curvature), video-assisted thoracoscopic surgical release with instrumentation (VATS-I), and VATS with PSF. FEV1 and FVC were fitted to model to evaluate the immediate postoperative pulmonary function (Yo), maximal recovery (Plateau), and rate (K) of pulmonary improvement. RESULTS: Patients in each surgical subgroup were as follows: PSF (Lenke 1: n=50, Lenke 2,3: n=20), ASF (Lenke 5, n=35), VATS-I (Lenke 1=31, Lenke 3=1), and VATS+PSF (Lenke1: n=9, Lenke 2-6: n=13). Early postoperative pulmonary function was higher with ASF and PSF as compared to both VATS groups (P<0.05). Comparing all curve types, VATS-I showed a small decline of absolute FEV1 compared to PSF at 2-years follow-up. Comparing thoracic curves, however, no differences in FEV1 or FVC were noted at 6 to 12 months until 2-years follow-up. The rate of recovery (K) was equivalent for all surgical approaches and curve types. CONCLUSION: Compared to ASF or PSF, VATS procedures showed an initial decline in pulmonary function, which resolved fully by 6- to 12-months follow-up. Modest declines in maximal pulmonary function with VATS-I were seen when comparing all curve types together but not when comparing Lenke 1 curves alone. VATS procedures for thoracic scoliosis and open approaches for thoracolumbar curve types were associated with minimal to no permanent deficits Keywords : Adolescent,analysis,Female,Follow-Up Studies,Forced Expiratory Volume,Humans,instrumentation,Joint Diseases,Lung,Male,Medical Records,methods,Outcome Assessment (Health Care),Patients,physiopathology,Postoperative Period,Recovery of Function,Respiratory Function Tests,Retrospective Studies,Scoliosis,Spinal Fusion,surgery,Time Factors,Vital Capacity,, Pulmonary,Recovery,After,Spinal,Fusion, st thomas hospital for spinal surgery

Date of Publication : 2011 Jun 15

Authors : Verma K;Lonner BS;Kean KE;Dean LE;Valdevit A;

Organisation : Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10017, USA

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21301397

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Maximal pulmonary recovery after spinal fusion for adolescent idiopathic scoliosis how do anterior approaches compare? | Complex regional pain syndrome pay out

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810