Spine Surgery and Related Research (Jan 2021)

Pulmonary Function Improves in Patients with Adolescent Idiopathic Scoliosis who Undergo Posterior Spinal Fusion Regardless of Thoracoplasty: A Mid-Term Follow-Up

  • Tsutomu Akazawa,
  • Toshiaki Kotani,
  • Tsuyoshi Sakuma,
  • Keita Nakayama,
  • Yasushi Iijima,
  • Yoshiaki Torii,
  • Masahiro Iinuma,
  • Shingo Kuroya,
  • Kota Asano,
  • Jun Ueno,
  • Atsuhiro Yoshida,
  • Kenichi Murakami,
  • Shohei Minami,
  • Sumihisa Orita,
  • Kazuhide Inage,
  • Yasuhiro Shiga,
  • Junichi Nakamura,
  • Gen Inoue,
  • Masayuki Miyagi,
  • Wataru Saito,
  • Yawara Eguchi,
  • Kazuki Fujimoto,
  • Hiroshi Takahashi,
  • Seiji Ohtori,
  • Hisateru Niki

DOI
https://doi.org/10.22603/ssrr.2020-0077
Journal volume & issue
Vol. 5, no. 1
pp. 22 – 27

Abstract

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Introduction: The purpose of the present study was to determine, in a mid-term follow-up 5 years or more after surgery, the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and expiratory flow in patients with adolescent idiopathic scoliosis (AIS) who underwent posterior spinal fusion (PSF) with or without thoracoplasty. Methods: The subjects were 134 patients with AIS who underwent PSF between 2004 and 2013. Forty-five patients agreed to participate in the study. We divided the patients into two groups as follows: 24 patients who underwent PSF with thoracoplasty from 2004 to 2010 in the TP group and 21 patients who underwent PSF without thoracoplasty from 2011 to 2013 in the non-TP group. We evaluated whole spine X-ray imaging and pulmonary function tests (PFTs) in these patients. PFTs measured FVC, FEV1, peak expiratory flow (PEF), maximum expiratory flow at 50% FVC (V50), maximum expiratory flow at 25% FVC (V25), and the ratio of V50 to V25 (V50/V25). Results: The main thoracic curves were 53.6 ± 10.1° before surgery, 19.8 ± 7.6° 1 week after surgery, 22.3 ± 8.3° 2 years after surgery, and 23.3 ± 7.6° at the most recent observation. Compared with preoperative values, FVC, FEV1, and % FEV1 were improved significantly at the most recent observation. No significant difference was observed between % FVC before surgery and at the most recent observation. Compared with preoperative values, PEF, V50, and V25 were improved significantly at the most recent observation. V50/V25 did not change significantly. The changes in PFT values in the TP group and the non-TP group were compared. No significant differences were observed in FVC, % FVC, FEV1, % FEV1, PEF, V50, or V25. Conclusions: Regardless of whether thoracoplasty was performed or not, FVC, FEV1, and expiratory flow were improved 5 years or later after PSF.

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