Cardiorespiratory Function Does Not Improve 2 Years After Posterior Surgical Correction of Adolescent Idiopathic Scoliosis

Lorente, Alejandro; Barrios, Carlos; Burgos, Jesús; Hevia, Eduardo; Fernández-Pineda, Luis; Lorente, Rafael; Rosa, Bárbara; Pérez-Encinas, Cristina

doi:10.1097/brs.0000000000002105

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…As the scoliosis patients at the LPO presented higher VR values, we suggested that ventilatory limitation may be the cause or contribute to exercise intolerance. 24 Although restrictive ventilatory disorders are described as frequent in AIS patients, 25 especially in curvatures greater than 45º, 5 we observed that even with slight residual curvatures after the surgical procedure, patients presented significantly lower FVC and FEV 1 values when compared to the CG. Studies have found increased pulmonary function (FVC and FEV 1 ) two years after the surgical procedure in AIS patients.…”

Section: Discussionmentioning

confidence: 64%

Functional Capacity in Adolescent Idiopathic Scoliosis During the Postoperative Period

Araújo

Saraiva

Sperandio

et al. 2019

Rev Bras Med Esporte

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Introduction: Patients with Adolescent Idiopathic Scoliosis (AIS) show reduced exercise capacity during the Incremental Shuttle Walk Test (ISWT). However, we not know how patients behave in the late postoperative (LPO) period. Objective: The aim of this study was to evaluate the ISWT distance (ISWTD) and physiological responses during ISWT in AIS patients during the LPO period. Methods: We included 22 patients with AIS in the LPO period (SG) and 21 adolescents in the Control Group (CG). We assessed pulmonary function (FVC and FEV1). During ISWT, a gas analyzer was used to assess peak oxygen (VO2) and submaximal relations: Oxygen Uptake Efficiency Slope (OUES) and the breathing pattern (ΔVT/ΔlnVE). Results: Significantly lower values were observed in SG: VO2 (22 ± 5 vs. 27 ± 4), ISWTD (567 ± 94 vs.604 ± 86), FVC (2.70 ± 0.47 vs. 3.33 ± 0.52) and FEV1 (2.41 ± 0.46 vs. 2.84 ± 0.52). There were significant correlations between ISWTD and VO2/Kg (r = 0.80); between OUES and ΔVT/ΔlnVE (r = 0.65); and between the main thoracic curve with VO2/Kg (r= −0.61). Conclusion: AIS patients in the LPO period have significantly reduced exercise capacity associated with reduced lung function, residual spinal curve and cardiovascular deconditioning. Level of Evidence III; Prognostic Studies - Investigation of the effect of characteristic of a patient on the outcome of the disease.

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Section: Discussionmentioning

confidence: 64%

Functional Capacity in Adolescent Idiopathic Scoliosis During the Postoperative Period

Araújo

Saraiva

Sperandio

et al. 2019

Rev Bras Med Esporte

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“…Seeking to understand the pre-and postoperative tolerance of individuals with AIS for aerobic exercise, it was possible to verify only three studies in the literature. [18][19][20] These studies did not report improved tolerance for exercise following AIS deformity correction surgery during two years of postoperative follow-up, and for this analysis the authors used the cardiopulmonary exercise test to measure the maximum oxygen consumption (VO 2 max) of the participants. The research that most resembles our study was developed by Araujo et al, 36 in which the authors evaluated tolerance for exercise in AIS patients in the postoperative period with a control group of healthy adolescents, using the incremental shuttle walk test (ISWT).…”

Section: Resultsmentioning

confidence: 99%

“…15,16 In this context, little is known about the effect of deformity correction surgery on exercise tolerance in AIS patients. [18][19][20] Lenke et al 18 were the first to evaluate ventilatory efficiency during physical exercise in patients with AIS submitted to deformity correction surgery and found no improvement in ventilatory efficiency in most patients. Subsequently, Jeans et al 19 and Lorente et al 20 also observed low cardiorespiratory tolerance for maximum physical exercise and no improvement following corrective surgery.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory Function of Patients With Adolescent Idiopathic Scoliosis

et al. 2021

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Objective: Adolescent idiopathic scoliosis (AIS) is a spinal deformity that can cause cardiorespiratory dysfunction, contributing to decreases in tolerance for aerobic exercise (TAE) and in functionality. The objective is to assess the TAE and lung capacity of patients who underwent corrective AIS surgery in the pre- (PRE) and postoperative (POST) periods. Methods: Sixty individuals, PRE (n=30, age: 18.5±2.4 years) and POST (n=30, age: 24.5±4.5 years), participated in the study. The forced vital capacity (FVC), the forced expiratory volume in the first second (FEV1) and the FEV1/FVC ratio, as well as the maximum inspiratory and expiratory pressure were verified. The TAE was assessed by the distance travelled in the 6-minute walk test (6MWT), together with blood pressure, heart rate, respiratory rate and peripheral oxygen saturation measured at the beginning and at the end of the test. Results: A mild restrictive pattern in lung function and reduced expiratory muscle strength were observed in both groups, but with no difference between the PRE and POST groups. No difference was found between the PRE (534±67.1 m) and POST (541± 69.5 m) groups for the distance travelled in the 6MWT, though both were below the predicted percentage (82.8±10.0% and 84.8±10.9%, respectively). Hemodynamic and respiratory changes caused by the 6MWT were observed, except for the peripheral oxygen saturation. Conclusion: The results suggest that even after surgical correction, patients with AIS continue to have low TAE. Level of evidence III; Therapeutics Study - Investigation of Treatment Results / Case-control study.

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“…A possible hypothesis is that the functional respiratory limitations described in patients with severe Scheuermann’s hyperkyphosis would benefit from surgical correction of the sagittal deformity. This issue has already been evaluated in patients with severe AIS who showed a limited tolerance to maximal cardiorespiratory exercise before surgery 4 . Both VO 2 max and VEmax remained essentially unchanged 2 years after surgical correction.…”

Section: Introductionmentioning

confidence: 99%

Cardiorespiratory function of patients undergoing surgical correction of Scheuermann's hyperkyphosis

Vera

Lorente

Burgos³

et al. 2021

Sci Rep

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The aim of this study was to analyze the impact of surgical correction of the thoracic deformity on the cardiorespiratory function of patients with moderate-severe Scheuermann’s hyperkyphosis (SK). A series of 23 adolescents with SK who underwent surgery through an only posterior approach using all pedicle screw constructs were included in the study. Cardiorespiratory parameters were measured during a maximal exercise tolerance test before and 2 years after surgery. Heart rate, oxygen saturation (SatO2), maximum oxygen uptake (VO2 max), ventilatory capacity at maximal exercise (VEmax), and energy costs were recorded. There were statistically significant differences in the forced vital capacity (FVC) (P < 0.05), total VO2max (ml/min) (P < 0.01), maximum expired volume (VEmax) per minute (P < 0.01) and cardiovascular efficiency (HR/VO2 ratio) (P < 0.05). None of these changes were clinically relevant. There were no changes in the VO2max per kg of body mass. The magnitude of the kyphosis correction did not correlate with the change in normalized VO2max or VEmax. In conclusion, patients with moderate-severe SK improve their baseline respiratory limitations and the tolerance to maximum exercise 2 years after surgery. However, the slight cardiorespiratory functional improvements should not necessarily be attributed to the surgery, and could also be caused solely by the residual growth of the lungs and thorax. Furthermore, respiratory functional changes are under thresholds considered as clinically relevant.

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Cardiorespiratory Function Does Not Improve 2 Years After Posterior Surgical Correction of Adolescent Idiopathic Scoliosis

Abstract: 3.

Cited by 13 publications

References 26 publications

Functional Capacity in Adolescent Idiopathic Scoliosis During the Postoperative Period

Functional Capacity in Adolescent Idiopathic Scoliosis During the Postoperative Period

Cardiorespiratory Function of Patients With Adolescent Idiopathic Scoliosis

Cardiorespiratory function of patients undergoing surgical correction of Scheuermann's hyperkyphosis

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