6 key notes on pulmonary function after spinal deformity surgery

A study recently published in The Journal of Bone and Joint Surgery examines pulmonary function after spinal deformity surgery in the adult population.

The researchers examined 164 patients who underwent surgical treatment at a single institution. The patients were followed for at least two years and the procedure was primary surgery for 100 of the patients.

The posterior-only surgical approach was used for 77 percent of the patients. Here are six key findings from the study.

1. A significant change in the major thoracic Cobb angle occurred in all patients. The average changes were:

• Thoracic Cobb angle: 47.4 degrees to 24.9 degrees
• Sagittal Cobb angle: 35.5 degrees to 30 degrees

2. There was a significant decline in absolute and percent-predicted pulmonary function values. The percent-predicted FEV1 decreased 5.3 percent and the percent-predicted forced vital capacity decreased 5.7 percent.

3. There was a clinically-significant decline — 10 percent or more in percent-predicted FEV1 — for around 27 percent of the patients.

4. Ten percent of the patients reported pulmonary impairment preoperatively and 14 percent reported pulmonary impairment after surgery. This change was not significant, and the patients with preoperative pulmonary impairment showed significant improvement in the absolute and percent-predicted FEV1 after surgery as compared to those without preoperative impairment.

5. The patients undergoing revision surgery had similar postoperative percent-predicted results to the patients undergoing primary surgery. But, revision surgeries were more often associated with a significant decline in pulmonary function.

6. The researchers found no difference in pulmonary function between patients who had posterior-only surgery and those who underwent the anterior/combined anterior-posterior procedures. There were also similar results when comparing by upper-instrumented vertebra.



Source: Becker's Spine Review, 9th Jan 2015