Pulmonary function in adolescent XXXX relative to the surgical procedure: a 10-year follow-up analysis.

@entity1 @entity2112
STUDY DESIGN: Retrospective review. OBJECTIVE: To assess long-term pulmonary function after surgical correction of adolescent @entity2112 . SUMMARY OF BACKGROUND DATA: Pulmonary function is known to decline with increasing age. Although there are published reports on 2- and 5-year pulmonary function test outcomesafter various surgical approaches for adolescent @entity2112 , 10-year pulmonary function tests of these @entity1 is unknown. METHODS: Forty-nine @entity1 were divided into two groups who underwent surgery for adolescent @entity2112 at a single institution. There were 46 female @entity1 and three male @entity1 . All group one @entity1 (n = 38) had some form of chest wall disruption during their spinal fusion: group 1A (n = 17) underwent open anterior spinal fusion/instrumentation, group 1B (n = 9) had a combined open anteroposterior spinal fusion, and group 1C (n = 12) had a posterior spinal fusion/instrumentation with thoracoplasty. Group 2 @entity1 (n = 11) underwent posterior spinal fusion/instrumentation with iliac crest bone graft and no chest cage disruption. We evaluated preoperative and 10-year pulmonary function test values. RESULTS: Within-group comparison revealed that group 1 experienced no change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)), but demonstrated a significant decrease in percent-predicted FVC (85% vs. 79%, P = 0.00086) and FEV(1) values (80% vs. 76%, P = 0.038). Conversely, group 2 experienced a significant increase in both FVC (3.25L vs. 3.66L, P = 0.011) and FEV(1) (2.77L vs. 3.10L, P = 0.0019), but no changes in percent-predicted values from baseline to 10 years. No changes were noted in percent-predicted values between 5 and 10 years in either group. CONCLUSION: Intraoperative chest wall violation produced detrimental pulmonary effects, as reflected by reduced percent-predicted values at 10-year follow-up. Posterior-only procedures, which spared the chest wall, showed significant improvements in FVC and FEV(1) absolute values without any change in percent-predicted values.
