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

DOI Web Site 21 References
  • Akazawa Tsutomu
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Kotani Toshiaki
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Sakuma Tsuyoshi
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Nakayama Keita
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Iijima Yasushi
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Torii Yoshiaki
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Iinuma Masahiro
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Kuroya Shingo
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Asano Kota
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Ueno Jun
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Yoshida Atsuhiro
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Murakami Kenichi
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine
  • Minami Shohei
    Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital
  • Orita Sumihisa
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Inage Kazuhide
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Shiga Yasuhiro
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Nakamura Junichi
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Inoue Gen
    Department of Orthopaedic Surgery, Kitasato University School of Medicine
  • Miyagi Masayuki
    Department of Orthopaedic Surgery, Kitasato University School of Medicine
  • Saito Wataru
    Department of Orthopaedic Surgery, Kitasato University School of Medicine
  • Eguchi Yawara
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Fujimoto Kazuki
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University Department of Orthopaedic Surgery, Konodai Hospital, National Center for Global Health and Medicine
  • Takahashi Hiroshi
    Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba
  • Ohtori Seiji
    Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University
  • Niki Hisateru
    Department of Orthopaedic Surgery, St. Marianna University School of Medicine

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Abstract

<p>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.</p><p>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).</p><p>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.</p><p>Conclusions: Regardless of whether thoracoplasty was performed or not, FVC, FEV1, and expiratory flow were improved 5 years or later after PSF.</p>

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