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Tag: adolescent|article link|pulmonary function|Scoliosis

Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure: A 10-Year Follow-up Analysis.

By wp_zaman

Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure: A 10-Year Follow-up Analysis.

Spine (Phila Pa 1976). 2011 Apr 7;

Authors: Gitelman Y, Lenke LG, Bridwell KH, Auerbach JD, Sides BA

STRUCTURED ABSTRACT: Study Design: Retrospective review.Objective: To assess long-term pulmonary function following surgical correction of adolescent idiopathic scoliosis (AIS).Summary of Background Data: Pulmonary function is known to decline with increasing age. Although there are published reports on 2- and 5-year pulmonary function test (PFT) outcomes following various surgical approaches for AIS, 10-year PFTs of these patients is unknown.Methods: 49 patients were divided into 2 groups who underwent surgery for AIS at a single institution. There were 46 females/3 males. All Group 1 patients (n = 38) had some form of chest wall disruption during their spinal fusion: Group 1a (n = 17) underwent open anterior spinal fusion/instrumentation (ASFI), Group 1b (n = 9) had a combined open anteroposterior spinal fusion (A/PSF) and Group 1c (n = 12) had a posterior spinal fusion/instrumentation (PSFI) with thoracoplasty. Group 2 patients (n = 11) underwent PSFI with iliac crest bone graft and no chest cage disruption. We evaluated preoperative and 10-year PFT values.Results: Within-group comparison revealed that Group 1 experienced no change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1), but demonstrated a significant decrease in percent-predicted FVC (85 vs. 79%, p = 0.00086) and FEV1 values (80 vs. 76%, p = 0.038). Conversely, Group 2 experienced a significant increase in both FVC (3.25 vs. 3.66L, p = 0.011) and FEV1 (2.77 vs. 3.10L, p = 0.0019), but no changes in percent-predicted values from baseline to 10 years. No changes were noted in percent-predicted values between 5 and 10 years in either group.Conclusion: Intraoperative chest wall violation produced detrimental pulmonary effects, as reflected by reduced percent-predicted values at 10-year follow-up. Posterior-only procedures, which spared the chest wall, showed significant improvements in FVC and FEV1 absolute values without any change in percent-predicted values.

PMID: 21494198 [PubMed – as supplied by publisher]