Pulmonary Function Following Adult Spinal Deformity Surgery: Minimum Two-Year Follow-Up

Lehman, Ronald A.; Kang, Daniel G.; Lenke, Lawrence G.; Sides, Brenda

doi:10.1016/j.spinee.2013.07.396

Cited by 5 publications

(7 citation statements)

References 37 publications

(56 reference statements)

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“…Generally, an approximate 5–10% increase of the PFT values was observed at 12 months after corrective surgery ( 25 ). A retrospective study conducted by Lehman revealed that adult patients with preoperative pulmonary impairment (FEV1 of < 65%) had an overall 2.7% improvement in pulmonary function at postoperative 2-year follow-up, which was significantly different from the decline in pulmonary function for all other patients ( 26 ). Therefore, we expected that the PFT results of our patients may be improved after correction and collected data to evaluate lung function at 2-year and 5-year follow-up postoperatively.…”

Section: Discussionmentioning

confidence: 95%

Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up

Zhou¹,

Zhang²,

Yang³

et al. 2022

Front. Med.

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BackgroundHalo gravity traction (HGT) has been reported to be a safe and effective adjunctive method for the management of scoliosis. However, the direct effects of HGT on the lung recovery of adult patients with scoliosis remain obscure.ObjectiveTo investigate changes in lung volume and pulmonary function in adult patients with severe scoliosis who underwent posterior spinal fusion concomitant with preoperative halo gravity traction.MethodsA total of 47 patients with a minimum 5-year follow-up who underwent posterior spinal instrumentation and fusion using preoperative halo–gravity traction were analyzed. Pulmonary function tests and three-dimensional CT were performed to evaluate changes in lung function and lung volume, respectively.ResultsThere was significant change in the Cobb angle of the major curve after halo gravity traction (P < 0.0001). Significant improvement in both Cobb angle (P < 0.0001) and thoracic kyphosis (P = 0.034) after corrective surgery was observed. Pulmonary function did not change significantly during traction. However, a significant decline in absolute and percent-predicted pulmonary function values was noted following surgery. The average change in lung volume did not show statistical differences during traction. At 5-year postoperative follow-up, the mean values revealed a significant increase in total lung volume (P < 0.0001) and concave lung volume (P < 0.0001) with surgical correction, but no statistically significant change in lung volume on the convex side (P = 0.57). Postoperative pulmonary complications occurred in nine cases with lower preoperative pulmonary function, indicating the importance of performing spirometry before corrective surgery.ConclusionsWe found that halo gravity traction prior to corrective surgery was less useful in improving pulmonary function in adult patients with severe scoliosis. However, these patients were expected to have increased lung volume after correction of the deformity.

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Section: Discussionmentioning

confidence: 95%

Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up

Zhou¹,

Zhang²,

Yang³

et al. 2022

Front. Med.

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“…‘Pulmonary function’ is not covered with the proposed outcome set. ‘Pulmonary function’ appears to be an important relevant outcome for patients [ 25 ], and it has been demonstrated to deteriorate after complex ASD surgery [ 26 , 27 ], but it is unclear what this domain entails and how to operationalize it. Furthermore, other as yet unknown domains may also become relevant, such as sleep deprivation, for which new (validated and reliable) measurement tools may become available.…”

Section: Discussionmentioning

confidence: 99%

The Scoliosis Research Society adult spinal deformity standard outcome set

et al. 2021

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Purpose Symptomatic adult spinal deformity (ASD) with an extremely variable presentation with pain, with and without neurogenic leg pain, and/or disturbed sagittal and coronal balance, causes a significant societal burden of disease. It is an important consequence of the aging adult population, generating a plethora of spine-related interventions with variable treatment efficacy and consistently high costs. Recent years have witnessed more than a threefold increase in the prevalence and treatment of ASD, and further increases over the coming decades are expected with the growing elderly population worldwide. The ability to monitor and assess clinical outcomes has not kept pace with these developments. This paper addresses the pressing need to provide a set of common outcome metrics for this growing group of patients with back pain and other disabilities due to an adult spinal deformity. Methods The standard outcome set was created by a panel with global representation, using a thorough modified Delphi procedure. The three-tiered outcome hierarchy (Porter) was used as a framework to capture full cycle of care. The standardized language of the International Classification of Functioning, Disability and Health (WHO-ICF) was used. Results Consensus was reached on a core set of 25 WHO-ICF outcome domains (‘What to measure’); on the accompanying globally available clinician and patient reported measurement instruments and definitions (‘How to measure’), and on the timing of the measurements (‘When to measure’). The current work has brought to light domains not routinely reported in the spinal literature (such as pulmonary function, return to work, social participation), and domains for which no adequate instruments have yet been identified (such as how to clinically quantify in routine practice lumbar spinal stenosis, neurogenic claudication, radicular pain, and loss of lower extremity motor function). Conclusion A standard outcome set was developed for patients undergoing treatment for adult spinal deformity using globally available outcome metrics. The current framework can be considered a reference for further work, and may provide a starting point for routine methodical and systematic monitoring of outcomes. Post-COVID e-health may accelerate the routine capture of these types of data.

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“…The influence of spinal corrective surgery on pulmonary function in patients with ASD is more controversial than it is for patients with AIS. There is a significant decline in pulmonary function 2 years after surgery to correct ASD, but patients with preoperative pulmonary impairment had improved pulmonary function 26 . In the present study, we found no significant improvement of respiratory dysfunction 1 year after surgery.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Key Radiographic Spinal Malalignment Parameters Associated with the Risk of Pulmonary Function Impairment in Patients Treated Surgically to Correct Adult Spinal Deformity

Endo

Ohba

Oba

et al. 2020

Spine Surg Relat Res

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Pulmonary Function Following Adult Spinal Deformity Surgery: Minimum Two-Year Follow-Up

Abstract: Background:The literature regarding pulmonary function in adult patients with spinal deformity is limited, and the effect

Cited by 5 publications

References 37 publications

Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up

Pulmonary Recovery Following Corrective Surgery in Adult Patients With Severe Scoliosis: A Minimum of Five-Year Follow-Up

The Scoliosis Research Society adult spinal deformity standard outcome set

Prevalence and Key Radiographic Spinal Malalignment Parameters Associated with the Risk of Pulmonary Function Impairment in Patients Treated Surgically to Correct Adult Spinal Deformity

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