How Does Pulmonary Function Change in Patients With Severe Thoracic Scoliosis 2 Years After One-Stage Low-Grade Osteotomy and Posterior Corrective Surgery?

OBJECTIVE

Severe scoliosis is often accompanied by moderate-to-severe pulmonary dysfunction. Numerous surgical methods are available for the treatment of severe scoliosis, but the effect of each method on postoperative pulmonary function (PF) remains controversial. Apical region correction and global balance (ACGB) is an effective surgical strategy to treat severe scoliosis, using Schwab I-II osteotomies and simple one-stage surgery. Herein, we explore the effect of the ACGB surgical strategy on postoperative PF values in patients with severe scoliosis at 2-year follow-up.

METHODS

Patients who underwent ACGB for scoliosis between 2015 and 2020 were enrolled, PF and radiological outcomes were evaluated preoperatively and at 2-year follow-up. PF values included forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and percent-predicted values (FVC% and FEV1%). Paired t-test, Pearson and Spearman correlation analyses, and multiple linear regression were used to analyze changes in PF values and associated factors.

RESULTS

In total, 36 patients (12 male and 24 female; mean age, 20.1 years) who underwent ACGB surgery were enrolled. Preoperative PF values showed restrictive ventilatory dysfunction. At 2-year follow-up, the PF values showed significant improvements. FVC, FEV1, FVC%, and FEV1% showed mean increases of 0.72, 0.68 L, 10.3%, and 9.8%, respectively. Changes in PF values were significantly correlated with age, thoracic height, preoperative FVC%, and preoperative FEV1%.

CONCLUSION

ACGB significantly improves PF in patients with severe scoliosis at 2-year follow-up. The increased thoracic height may be crucial for improving PF values, while patients with poorer preoperative PF may show greater postoperative improvement.