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Thread: Long term follow up of pulmonary function>20 years in treated scoliosis

  1. #1
    Join Date
    Sep 2003
    Location
    NJ
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    1,291

    Long term follow up of pulmonary function>20 years in treated scoliosis

    PULMONARY FUNCTION INCREASES AFTER SCOLIOSIS TREATMENT

    Most patients with adolescent idiopathic scoliosis who are treated with posterior spinal surgery or bracing experience improved pulmonary function for up to 25 years after treatment, say the authors of a long-term follow-up study.

    Pehrsson et al examined lung volumes and respiratory symptoms in 251 patients who had been treated for adolescent idiopathic scoliosis at least 20 years earlier: 141 treated surgically with posterior fusion and 110 with a brace. One hundred age- and gender-matched subjects without scoliosis served as controls.

    All 251 scoliosis patients had undergone lung volume measurements before surgery or bracing. Repeat measurements were obtained a mean of 1.4 years after treatment in the surgical patients and a mean of 25 years after treatment in both groups.

    Among the surgical patients, vital capacity (VC) as a percentage of predicted was 67% before treatment, 73% at the 1.4-year follow-up, and 84% at the most recent follow-up; forced expiratory volume in one second (FEV1) as a percentage of predicted was 71%, 78%, and 84%, respectively. Among the patients given braces, predicted VC rose from 77% before treatment to 89% at follow-up; predicted FEV1 increased from 84% to 91%. None of these measurements of lung volume were significantly different from those of controls.

    The incidence of dyspnea was similarly low (3% or less) in all three groups. Wheezing was slightly more common in the scoliosis patients (33% in the surgical patients; 30% in those given braces) than in the controls (23%), but the difference did not reach significance.

    The mean Cobb angles in the two treatment groups were 62° and 33°, respectively, before treatment, and 37° and 38°, respectively, at the 25-year follow-up. Neither pretreatment nor posttreatment Cobb angles correlated with the patients’ adult lung volumes.

    Pehrsson K, Danielsson A, Nachemson A. Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment. Thorax. 2001;56:388-393.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  2. #2
    Join Date
    Jan 2006
    Posts
    513
    That's good to know. It makes sense.
    God has used scoliosis to strengthen and mold us. He's good all the time!On this forum these larger curves have not held forever in Spinecor,with an initial positive response followed by deterioration. With deterioration, change treatment.The first year she gained 4 or 5 inches and was stable at around 20/20 in brace, followed by rapid progression the next year.She is now 51/40 (Jan2008)out of brace (40/30 in Spinecor) and started at 38/27 out of brace(Jan2006.) Now in Cheneau.

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