J Korean Soc Spine Surg.  2004 Sep;11(3):174-180. 10.4184/jkss.2004.11.3.174.

Comparision of the pulmonary function between open anterior release and thoracoscopic anterior release

• Lee JS
• Park WR
• Park WW
• Suh KT

• KMID: 1839989
• DOI: http://doi.org/10.4184/jkss.2004.11.3.174

Abstract

STUDY DESIGN: Retrospective study
OBJECTIVES
To evaluate the results of a serial pulmonary function test in severe scoliosis that required an anterior release and posterior fusion SUMMARY OF LITERACTURE REVIEW: There are a few reports on the pulmonary function after an anterior release and posterior fusion in severe scoliosis.
MATERIALS AND METHODS
Twenty two cases of severe scoliosis requiring an anterior release and posterior fusion were followed up more than 2 years. The patients were divided into two groups (group 1: 10 cases of open thoracotomy and posterior fusion, group 2: 12 cases of thoracoscopic release and posterior fusion). The forced vital capacity (FVC), forced expiratory volume 1 (FEV1), total lung capacity (TLC), the predicted FVC, predicted FEV1 and predicted TLC in the preoperative, 3 month, 6 month, 1 year, 2 year postoperative period in the two groups were compared. Statistical analysis was performed using a paired T-test.
RESULTS
The average preoperative FVC in groups 1 and 2 were checked as 2.20 L and 2.30 L, respectively. The postoperative 3 month FVC were checked as 1.60 L and 1.81 L, respectively, which were the lowest levels throughout the serial follow-up. The postoperative 6 month FVC were 1.70 L and 2.15 L, respectively. The postoperative 2 year FVC were 2.17 L and 2.18 L, respectively, which were 98.6% and 94.8% of the preoperative FVC. The average preoperative FEV1 of group 1 was 1.95 L. The post-operative 3 month FEV1 were at the lowest level and the postoperative 2 year FEV1 was 1.80 L (92.3% of preoperative value). The average preoperative FEV1 of group 2 was 2.05 L. The postoperative 6 month FEV1 was 1.90 L (92.7% of preoperative value). The TLC of group 2 showed a faster recovery than that of group 1. The predicted FVC, FEV1 and TLC of both groups at 2 years after surgery were 2 ~4% lower than the baseline. The recovery pattern in group 1 was steady for 2 years. The postoperative 6-month value was similar to the postoperative 2-year value in group 2.
CONCLUSIONS
In severe scoliosis with a decreased pulmonary function, those undergoing thoracoscopic anterior release had a faster pulmonary function recovery than those undergoing an open thoracotomy.

Keyword

Severe scoliosis; Open thoracotomy; Thoracoscopy; Pulmonary function test

MeSH Terms

Follow-Up Studies
Forced Expiratory Volume
Humans
Postoperative Period
Recovery of Function
Respiratory Function Tests
Retrospective Studies
Scoliosis
Thoracoscopy
Thoracotomy
Total Lung Capacity
Vital Capacity

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