Analysis of the pulmonary function in patients undergoing vertebral body tethering for adolescent idiopathic scoliosis

Eur Spine J. 2022 Apr;31(4):1022-1027. doi: 10.1007/s00586-021-07029-2. Epub 2021 Oct 22.

Abstract

Purpose: The literature concerning the effects of scoliosis correction on pulmonary function (PF) is scarce and solely related to spinal fusion. Vertebral body tethering (VBT) represents a new option for scoliosis correction; however, its effects on PF have not yet been investigated. As VBT is a fusion-less technique that does not limit the dynamics of the chest wall, it is expected not to have a negative impact on PF despite the anterior surgical approach.

Methods: We analyzed the PF preoperatively and compared it with the PF at 6-weeks, 6-months and 12-monthts postoperatively. Considered parameters were total lung capacity (TLC), forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) expressed as percentages. A change of more than 10% was considered clinically significant.

Results: Before VBT, overall TLC, FEV1 and FVC measured 98 ± 15%, 85 ± 16% and 91 ± 17%, respectively. Six weeks after surgery, all parameters were comparable to the preoperative values (TLC 96 ± 17%, FEV1 84 ± 14%, FVC 90 ± 16%) and remained so at the last follow-up (TLC 99 ± 15%, FEV1 89 ± 9%, FVC 86 ± 9). While a reduction in FEV1 and FVC was observed at 6-weeks and 6-months in patients with thoracic or double curves compared to thoracolumbar curves, no significant differences were observed at the 12-months follow-up.

Conclusions: VBT does not cause a reduction in PF values at a short-term follow-up.

Keywords: Adolescent idiopathic scoliosis; Anterior fusion-less scoliosis correction; Pulmonary function; Vertebral body tethering.

MeSH terms

  • Adolescent
  • Forced Expiratory Volume
  • Humans
  • Kyphosis*
  • Retrospective Studies
  • Scoliosis* / surgery
  • Spinal Fusion* / methods
  • Thoracic Vertebrae / surgery
  • Vertebral Body
  • Vital Capacity