Prospective Pulmonary Function Comparison of Anterior Spinal Fusion in Adolescent Idiopathic Scoliosis: Thoracotomy vs. Thoracoabdominal Approach

Summary: 59 adolescent idiopathic scoliosis patients undergoing an anterior spinal instrumentation and fusion through an open thoracotomy were compared to 46 patients treated with a thoracoabdominal approach. At 2 years follow-up, an open thoracotomy approach for treating a MT curve demonstrated a significant decrease in the absolute value of PFTs at 2 years postoperative compared to those through a thoracoabdominal approach for treating a TL/L curve.

Purpose: To evaluate pulmonary function changes at 2-year postoperative follow-up in 105 adolescent idiopathic scoliosis (AIS) patients undergoing either a thoracotomy versus thoracoabdominal anterior spinal instrumentation and fusion.

Methods: 59 AIS patients underwent an anterior spinal instrumentation and fusion through an open thoracotomy (TC group) for a major main thoracic (MT) scoliosis were compared to 46 patients who underwent the same procedure through a thoracoabdominal approach (TA group) for a major thoracolumbar/lumbar (TL/L) scoliosis.

Results: The average major curve Cobb correction was 31 degrees (49% correction) in the TC group versus 35 degrees (72% correction) in the TA group (p<0 .001). The average changes in thoracic kyphosis angle was 9 degree increase the TC group and 3 TA (p="0.75)." Preoperative 2-year postoperative absolute FVC averaged 3.11 liters, 2.77 liters respectively corresponding results of were 3.36 3.29 FEV-1 2.61 2.37 2.89 2.86 Two years following surgery, demonstrated significantly decreased pulmonary function values compared to that (FVC; 0.34L decrease vs 0.07L group, p<0.001) (FEV1; 0.23L 0.04L p="0.004)."

Conclusions: An open thoracotomy approach for treating a MT curve demonstrated a significant decrease in the absolute value of PFTs at 2 years postoperative compared to those through a thoracoabdominal approach for treating a TL/L curve.