Surgical Approach May Affect Lung Function in Scoliosis
Thoracotomy and thoracoscopy associated with reduced lung function in adolescents
MONDAY, Dec. 21 (HealthDay News) -- In adolescents with scoliosis who undergo surgery, thoracotomy and thoracoscopy are associated with declines in lung function, while thoracoabdominal surgery has no significant effect, according to a study in the December issue of the Journal of Spinal Disorders & Techniques.
Baron S. Lonner, M.D., from the New York University Hospital for Joint Diseases in New York City, and colleagues examined pulmonary function in patients with adolescent idiopathic scoliosis who had undergone anterior spinal surgery, where 68 patients had open thoracotomy, 44 patients had thoracoscopic surgery with and without thoracoplasty, and 19 patients had a thoracoabdominal approach.
Two years after surgery, the researchers found that thoracotomy was associated with greater declines than thoracoscopic surgery in percent-predicted forced expiratory volume in one second and forced vital capacity. Percent-predicted total lung capacity decreased after thoracotomy but increased after thoracoscopic surgery. Thoracoscopic patients who underwent thoracoplasty had reduced lung function compared with patients who did not undergo thoracoplasty. The thoracoabdominal group had no significant changes in lung function.
"Slight declines in pulmonary function at two-year follow-up were noted in both the thoracotomy and thoracoscopic groups, but to a significantly greater extent in those with an open thoracotomy," Lonner and colleagues conclude. "No significant diminishment was noted for the thoracoabdominal approach, despite disruption of the diaphragm."
Depuy Spine provided funding to the Harms Study Group.