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:10.22603/ssrr.2020-0077

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

Spine Surg Relat Res. 2020 Aug 31;5(1):22-27. doi: 10.22603/ssrr.2020-0077. eCollection 2021.

Authors

Tsutomu Akazawa^{1

2}, Toshiaki Kotani², Tsuyoshi Sakuma², Keita Nakayama², Yasushi Iijima², Yoshiaki Torii¹, Masahiro Iinuma¹, Shingo Kuroya², Kota Asano¹, Jun Ueno¹, Atsuhiro Yoshida¹, Kenichi Murakami¹, Shohei Minami², Sumihisa Orita³, Kazuhide Inage³, Yasuhiro Shiga³, Junichi Nakamura³, Gen Inoue⁴, Masayuki Miyagi⁴, Wataru Saito⁴, Yawara Eguchi³, Kazuki Fujimoto^{3

5}, Hiroshi Takahashi⁶, Seiji Ohtori³, Hisateru Niki¹

Affiliations

¹ Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
² Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, Sakura, Japan.
³ Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁴ Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
⁵ Department of Orthopaedic Surgery, Konodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan.
⁶ Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

Abstract

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.

Keywords: adolescent idiopathic scoliosis; expiratory flow; pulmonary function; thoracoplasty.