A Change of Pulmonary Function in the Patients with Severe Non-Idiopathic Scoliosis Following Reconstructive Spine Surgery / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: This is a retrospective study OBJECTIVES: We wanted to investigate the changes in pulmonary function after spine surgery for the patients suffering with severe non-idiopathic scoliosis. SUMMARY OF LITERATURE REVIEW: The potential for pulmonary function change after scoliosis surgery may be much greater for the patients with neuromuscular, congenital or neuro-fibromatosis because of the severe thoracic deformity. Yet few studies have been performed on this subject. MATERIALS AND METHODS: 12 non-idiopathic scoliosis patients (average age: 11.1 years) were followed up for more than one year. Among these patients, 7 had muscular dystrophy, 3 had spinal muscular atrophy, 1 had Guillain-BarreSyndrome and 1 had neuro-fibromatosis. Surgery was done through the anterior and posterior approaches in 7 cases, and the posterior approach was used in 5 cases. In the former group, open thoracotomy was performed in 6 cases. NIPPV (non-invasive positive pressure ventilation) was used for 4 patients before surgery. RESULTS: The average Cobb's angle improved from preoperative 93.9 to postoperative 42.4, showing 55% correction. The average FVC was 1270ml before surgery and 1365 ml postoperatively, and the average FEV1 was 1163 ml preoperatively and 1300 ml postoperatively, showing a slightly increased FEV1. When these data were analyzed in detail, the FVC was decreased from preoperative 72.3% to 63.8% postoperatively in the 6 patients who underwent open thoracotomy. On the other hand, it was increased from preoperative 43% to 47.5% postoperatively in the 6 patients who did not undergo thoracotomy. CONCLUSION: Although the pulmonary function deteriorated after reconstructive spine surgery in some patients, worsening was seen mainly in those patients who underwent thoracotomy. The pulmonary function was actually improved in the patients who underwent surgery without thoracotomy to correct their severe scoliosis