Pulmonary function before and after surgical correction of scoliosis.

Kumano, K; Tsuyama, Naoichi

doi:10.2106/00004623-198264020-00016

Cited by 58 publications

(22 citation statements)

References 19 publications

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“…Whereas in idiopathic scoliosis the deformity itself is the cause of functional deterioration, in patients with neuromuscular disease the underlying disease persists even after the deformity is corrected. As to the status of lung function at long-term, some studies have provided evidence of improved pulmonary function at 1-2 years following surgery [5,8], whereas in others this improvement was not observed [4,10,12]. In the present study, FVC was 26% (range 13-39%) of the theoretical value preoperatively.…”

Section: Discussioncontrasting

confidence: 53%

Severe restrictive lung disease and vertebral surgery in a pediatric population

et al. 2009

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The aim of this study is to describe the outcome of surgical treatment for pediatric patients with forced vital capacity (FVC) \40% and severe vertebral deformity. Few studies have examined surgical treatment in these patients, who are considered to be at a high risk because of their pulmonary disease, and in whom preoperative tracheostomy is sometimes recommended. Inclusion criteria include FVC \40%, age \19 years and diagnosis of scoliosis. The retrospective study of 24 patients with severe restrictive lung disease, who underwent spinal surgery. Variables studied were age and gender, pre-and postoperative spirometry (FVC, FEV1, FEV1/FVC), preoperative, postoperative and late use of non-invasive ventilation (BiPAP) or mechanical ventilation, associated multidisciplinary treatment, type and location of the curve, pre-and postoperative curve values, type of vertebral fusion, intraand postoperative complications, duration of intensive care unit (ICU) stay and length of postoperative hospitalization. Mean age was 13 years (9-19) of which 13 were males and 11 females. Mean follow-up was 32 months (24-45). The etiology was neuromuscular in 17 patients and other etiologies in 7 patients. Mean preoperative FVC was 26%

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Section: Discussioncontrasting

confidence: 53%

Severe restrictive lung disease and vertebral surgery in a pediatric population

et al. 2009

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“…The reported results of Harrington instrumentation and posterior spinal arthrodesis with iliac crest bone graft on pulmonary function have varied from an improvement in pulmonary function after surgery [4][5][6][7][9][10][11] to no change 12,14 or to a postoperative decline in pulmonary function [17][18][19] . After the introduction of modern segmental spinal instrumentation systems with multiple hook and rod constructs aiming at three-dimensional correction, the reported pulmonary function values have also varied, showing an improvement in pulmonary function after surgery 8,32 to no change 15 or to a postoperative decline in pulmonary function [17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have focused on pulmonary function test changes after anterior spinal arthrodesis with a rib resection in patients with adolescent idiopathic scoliosis 7,15,35,36 . The pulmonary function test values after anterior spinal arthrodesis with a rib resection demonstrated no change 15 or a decrease at the time of the final follow-up 7,35,36 .…”

Section: Discussionmentioning

confidence: 99%

“…The effect of surgical correction on the pulmonary function of patients with adolescent idiopathic scoliosis is controversial. Although some investigators have shown that surgical correction of scoliosis substantially improves measured pulmonary functions such as vital capacity [4][5][6][7][8][9][10][11] , others have demonstrated no major improvement in pulmonary function after operative correction [11][12][13][14][15] or have reported loss of pulmonary function postoperatively [15][16][17][18][19] . The controversies could perhaps be attributed to the fact that these studies were done on nonhomogeneous populations with different treatment modalities, age distribution, gender, curve patterns, curve severity, and etiology of the scoliosis and with various measurement techniques and parameters of pulmonary function evaluation such as the use of absolute versus percent-predicted values.…”

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Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure

Kim

Lenke

KIM

et al. 2005

The Journal of Bone and Joint Surgery-American Volume

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“…Patients with rigid spinal deformity often combine with severe pulmonary function impairment, and many researches have shown that anterior spinal surgery had great impact on pulmonary function [7]. PVCR, however,could not only correct the deformities as good as or better than other surgery, but also could avoid anterior approachrelated complications, particularly to pulmonary function impairment.…”

Section: Pvcr Techniquementioning

confidence: 99%

Change in Cobb angle of each segment of the major curve after posterior vertebral column resection (PVCR): a preliminary discussion of correction mechanisms of PVCR

Xie

Wang

et al. 2011

Eur Spine J

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Introduction Posterior vertebral column resection (PVCR) is an effective technique for treating severe rigid spinal deformities, and no other osteotomy is capable for such an excellent corrective effects. The purpose of this study was to discuss the correction mechanisms of PVCR. Materials and methods Forty-six patients with severe rigid spinal deformities undergoing PVCR were retrospectively analyzed. According to a routine posteroanterior supine entire spine radiograph performed before and after surgery, the major curve at coronal plane was divided into three segments factitiously: upper segment (from the superior endplate of the upper vertebra of the major curve to the inferior endplate of the upper vertebra adjacent to the resected vertebra), middle segment (from the inferior endplate of the upper vertebra adjacent to the resected vertebra to the superior endplate of the lower vertebra of the resected vertebra), and lower segment (from the superior endplate of the lower vertebra of the resected vertebra to the inferior endplate of the lower end vertebra of the major curve). Cobb method was used to measure the curvature of the major curve and each segment. We analyzed the changes of the Cobb angle in the major curve and each segment. We also analyzed the correlation between the placement of pedicle screws and deformity correction. Results The Cobb angle of the major curve decreased from 110.1 ± 18.1°to 51.0 ± 17.3°(p \ 0.05) after surgery (decreased by 59.1 ± 16.4°), the mean correction rate was 54.1 ± 12.2% (p \ 0.05). The Cobb angle of the middle segment decreased by 28.1 ± 14.7°(p \ 0.05), the contribution rate was 49.1 ± 27.3%. The upper and lower segments decreased by 15.7 ± 13.1°and 15.3 ± 12.4°, respectively (p \ 0.05). There were no significant differences in the contribution rate between upper and lower segments (25.2 ± 16.6% vs. 26.3 ± 22.6%) (p [ 0.05). 22 patients were instrumented with at least one pedicle screw in the adjacent upper and lower vertebras of the resected vertebra and gained a better corrective effect in comparison with the others (p \ 0.05). The data also indicated that deformity correction was closely related to the numbers of the pedicle screws (r = 0.82, p \ 0.05). Conclusion In conclusion, the middle segment offered the highest contribution rate to the deformity correction of the major curve, but at the same time the spinal cord was angulated in this segment. So, it is dangerous to gain too much deformity correction in the middle segment. Because spine would shorten and the tension in spinal cord would decrease after vertebral column resection, a better correction effect could be gained in upper and lower segments at a low risk of spinal cord injury. But it was actually too hard for such rigid spinal deformity. It could gain a better corrective effect and stability by placing more pedicle screws at major curve, especially at the upper and lower vertebras adjacent to the resected vertebra, but sometimes it was difficult to place enough pedicle screws in severe rigid spin...

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Pulmonary function before and after surgical correction of scoliosis.

Cited by 58 publications

References 19 publications

Severe restrictive lung disease and vertebral surgery in a pediatric population

Severe restrictive lung disease and vertebral surgery in a pediatric population

Pulmonary Function in Adolescent Idiopathic Scoliosis Relative to the Surgical Procedure

Change in Cobb angle of each segment of the major curve after posterior vertebral column resection (PVCR): a preliminary discussion of correction mechanisms of PVCR

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