Pulmonary Function in Patients with Adolescent Idiopathic Scoliosis 25 Years After Surgery or Start of Brace Treatment
Kerstin Pehrsson, MD,
PhD;
Aina Danielsson, MD;
Alf Nachemson, MD, PhD
Sahlgrenska University Hospital– GÖTEBORG, SWEDEN
PURPOSE:
To determine the long–term outcome of pulmonary function
in patients treated by posterior fusion or brace treatment and
identify risk factors for reduction of pulmonary function.
METHODS:
A consecutive group of patients treated by posterior surgery
or brace 25 years ago was investigated. 90% attended a clinical
follow–up. Vital capacity (VC), forced expiratory volume
(FEV1) and total lung capacity (TLC) was determined in 251 patients
before treatment, 18 months after surgery in 141 patients and
25 years after surgery or start of brace treatment (n=110). The
results were corrected for loss of height due to scoliosis. VC
was calculated in % predicted according to height and age. Cobb
angles were measured. Smoking habits were recorded and an age
and sex match control group was also examined.
RESULTS:
Mean VC increased from 3.1 liters (1) before surgery to 3.51
after surgery and 3.61 at present follow–up after 25 years.
VC in % predicted increased from 67 before surgery to 73 after
surgery and 84 (p<0.001) at present follow–up. In the
brace treated patients the VC was 3.41 before and 3.81 at present
follow–up and VC in % predicted 77% and 89% (p<0.001)
respectively. FEV1 and TLC also increased. VC in % predicted
was 103% in the control group. Mean Cobb angle at present follow–up
was 40 degrees in both surgically and brace treated patients.
The present results of VC or FEV1 did not correlate to Cobb angles
or smoking habits.
CONCLUSION:
Patients treated by posterior fusion or brace treatment gradually
increase their pulmonary function long time after treatment.
In this patient group VC was 85% of predicted normal 25 years
after surgery or brace treatment. We could not identify any risk
factors for the reduction of pulmonary function.