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Departments
of Orthopaedics and Pulmonary Medicine, Sahlgrenska University
Hospital, Göteborg University, SE-413 45 Göteborg and Department of
Respiratory Medicine, Malmö University Hospital, SE 205 02 Malmö,
Sweden
Correspondence to: Dr K Pehrsson, Malmö University Hospital, SE-205 02 Malmö, Sweden Kerstin.Pehrsson{at}lung.mas.lu.se
Received 19 June 2000; Returned to authors 22 August 2000; Revised version received 9 January 2001; Accepted for publication 22 January 2001
BACKGROUND
Pulmonary
function in patients with adolescent idiopathic scoliosis many years
after posterior spinal surgery or brace treatment has not been documented.
METHODSA consecutive
group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up.
Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or
start of brace treatment in 110 patients. Vital capacity (VC) was
calculated as percentage predicted according to height and age and the
results were corrected for loss of height due to scoliosis. Scoliosis
angles were measured and smoking habits were recorded. An age and sex
matched control group was also examined with the same questionnaire and
pulmonary function tests.
RESULTSVC increased
from 67% predicted immediately before surgery to 73% (p<0.001) after
surgery and to 84% (p<0.001) at the present follow up, mean change
10.8% (95% CI 9.5 to 12.1). In the brace treated patients VC
increased from 77% predicted before treatment to 89% (p<0.001) 25 years after start of treatment, mean change 12.3% (95% CI 10.5 to
14.1). The mean Cobb angle at the present follow up study was 40° in
both surgically and brace treated patients. The present results of lung
volumes did not correlate with pretreatment or post-treatment Cobb
angles or smoking habits.
CONCLUSIONSPatients
treated by posterior fusion or a brace gradually increase their
pulmonary function up to 25 years after treatment. Smoking and curve
size are not risk factors for reduced pulmonary function.
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