Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment

BACKGROUND Pulmonary function in patients with adolescent idiopathic scoliosis many years after posterior spinal surgery or brace treatment has not been documented. METHODS A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% atten...

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Published in:Thorax 2001-05, Vol.56 (5), p.388-393
Main Authors: Pehrsson, K, Danielsson, A, Nachemson, A
Format: Article
Language:English
Subjects:
Adolescent
adolescent idiopathic scoliosis
Age
Analysis
Back surgery
Biological and medical sciences
Braces
Child
Complications and side effects
Dyspnea
Dyspnea - etiology
etiology
Female
Follow-Up Studies
Forced Expiratory Volume
Forced Expiratory Volume - physiology
Humans
long term outcome
Lung
Lung - physiology
Male
Medical sciences
Original
Orthopedic surgery
Orthopedics
Ortopedi
Ostomy
Outcome and process assessment (Health Care)
Patients
Pediatric respiratory diseases
physiology
physiopathology
pulmonary function
Pulmonary function tests
Questionnaires
Respiratory failure
Respiratory insufficiency
Risk factors
Scoliosis
Scoliosis - physiopathology
Scoliosis - surgery
Smoking
Smoking - physiopathology
surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vital Capacity
Vital Capacity - physiology
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Danielsson, A
Nachemson, A
description BACKGROUND Pulmonary function in patients with adolescent idiopathic scoliosis many years after posterior spinal surgery or brace treatment has not been documented. METHODS A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up. Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or start of brace treatment in 110 patients. Vital capacity (VC) was calculated as percentage predicted according to height and age and the results were corrected for loss of height due to scoliosis. Scoliosis angles were measured and smoking habits were recorded. An age and sex matched control group was also examined with the same questionnaire and pulmonary function tests. RESULTS VC increased from 67% predicted immediately before surgery to 73% (p
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METHODS A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up. Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or start of brace treatment in 110 patients. Vital capacity (VC) was calculated as percentage predicted according to height and age and the results were corrected for loss of height due to scoliosis. Scoliosis angles were measured and smoking habits were recorded. An age and sex matched control group was also examined with the same questionnaire and pulmonary function tests. RESULTS VC increased from 67% predicted immediately before surgery to 73% (p&lt;0.001) after surgery and to 84% (p&lt;0.001) at the present follow up, mean change 10.8% (95% CI 9.5 to 12.1). In the brace treated patients VC increased from 77% predicted before treatment to 89% (p&lt;0.001) 25 years after start of treatment, mean change 12.3% (95% CI 10.5 to 14.1). The mean Cobb angle at the present follow up study was 40° in both surgically and brace treated patients. The present results of lung volumes did not correlate with pretreatment or post-treatment Cobb angles or smoking habits. CONCLUSIONS Patients treated by posterior fusion or a brace gradually increase their pulmonary function up to 25 years after treatment. Smoking and curve size are not risk factors for reduced pulmonary function.</description><identifier>ISSN: 0040-6376</identifier><identifier>EISSN: 1468-3296</identifier><identifier>DOI: 10.1136/thorax.56.5.388</identifier><identifier>PMID: 11312408</identifier><identifier>CODEN: THORA7</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Thoracic Society</publisher><subject>Adolescent ; adolescent idiopathic scoliosis ; Age ; Analysis ; Back surgery ; Biological and medical sciences ; Braces ; Child ; Complications and side effects ; Dyspnea ; Dyspnea - etiology ; etiology ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; Forced Expiratory Volume - physiology ; Humans ; long term outcome ; Lung ; Lung - physiology ; Male ; Medical sciences ; Original ; Orthopedic surgery ; Orthopedics ; Ortopedi ; Ostomy ; Outcome and process assessment (Health Care) ; Patients ; Pediatric respiratory diseases ; physiology ; physiopathology ; pulmonary function ; Pulmonary function tests ; Questionnaires ; Respiratory failure ; Respiratory insufficiency ; Risk factors ; Scoliosis ; Scoliosis - physiopathology ; Scoliosis - surgery ; Smoking ; Smoking - physiopathology ; surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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METHODS A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up. Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or start of brace treatment in 110 patients. Vital capacity (VC) was calculated as percentage predicted according to height and age and the results were corrected for loss of height due to scoliosis. Scoliosis angles were measured and smoking habits were recorded. An age and sex matched control group was also examined with the same questionnaire and pulmonary function tests. RESULTS VC increased from 67% predicted immediately before surgery to 73% (p&lt;0.001) after surgery and to 84% (p&lt;0.001) at the present follow up, mean change 10.8% (95% CI 9.5 to 12.1). In the brace treated patients VC increased from 77% predicted before treatment to 89% (p&lt;0.001) 25 years after start of treatment, mean change 12.3% (95% CI 10.5 to 14.1). The mean Cobb angle at the present follow up study was 40° in both surgically and brace treated patients. The present results of lung volumes did not correlate with pretreatment or post-treatment Cobb angles or smoking habits. CONCLUSIONS Patients treated by posterior fusion or a brace gradually increase their pulmonary function up to 25 years after treatment. Smoking and curve size are not risk factors for reduced pulmonary function.</description><subject>Adolescent</subject><subject>adolescent idiopathic scoliosis</subject><subject>Age</subject><subject>Analysis</subject><subject>Back surgery</subject><subject>Biological and medical sciences</subject><subject>Braces</subject><subject>Child</subject><subject>Complications and side effects</subject><subject>Dyspnea</subject><subject>Dyspnea - etiology</subject><subject>etiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forced Expiratory Volume</subject><subject>Forced Expiratory Volume - physiology</subject><subject>Humans</subject><subject>long term outcome</subject><subject>Lung</subject><subject>Lung - physiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Original</subject><subject>Orthopedic surgery</subject><subject>Orthopedics</subject><subject>Ortopedi</subject><subject>Ostomy</subject><subject>Outcome and process assessment (Health Care)</subject><subject>Patients</subject><subject>Pediatric respiratory diseases</subject><subject>physiology</subject><subject>physiopathology</subject><subject>pulmonary function</subject><subject>Pulmonary function tests</subject><subject>Questionnaires</subject><subject>Respiratory failure</subject><subject>Respiratory insufficiency</subject><subject>Risk factors</subject><subject>Scoliosis</subject><subject>Scoliosis - physiopathology</subject><subject>Scoliosis - surgery</subject><subject>Smoking</subject><subject>Smoking - physiopathology</subject><subject>surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Vital Capacity</topic><topic>Vital Capacity - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pehrsson, K</creatorcontrib><creatorcontrib>Danielsson, A</creatorcontrib><creatorcontrib>Nachemson, A</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Göteborgs universitet</collection><jtitle>Thorax</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pehrsson, K</au><au>Danielsson, A</au><au>Nachemson, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment</atitle><jtitle>Thorax</jtitle><addtitle>Thorax</addtitle><date>2001-05-01</date><risdate>2001</risdate><volume>56</volume><issue>5</issue><spage>388</spage><epage>393</epage><pages>388-393</pages><issn>0040-6376</issn><eissn>1468-3296</eissn><coden>THORA7</coden><abstract>BACKGROUND Pulmonary function in patients with adolescent idiopathic scoliosis many years after posterior spinal surgery or brace treatment has not been documented. METHODS A consecutive group of patients treated by posterior fusion or a brace at least 20 years previously was investigated. 90% attended a clinical follow up. Lung volumes were determined before treatment in 251 patients, 1.4 years after surgery in 141 patients, and 25 years after surgery or start of brace treatment in 110 patients. Vital capacity (VC) was calculated as percentage predicted according to height and age and the results were corrected for loss of height due to scoliosis. Scoliosis angles were measured and smoking habits were recorded. An age and sex matched control group was also examined with the same questionnaire and pulmonary function tests. RESULTS VC increased from 67% predicted immediately before surgery to 73% (p&lt;0.001) after surgery and to 84% (p&lt;0.001) at the present follow up, mean change 10.8% (95% CI 9.5 to 12.1). In the brace treated patients VC increased from 77% predicted before treatment to 89% (p&lt;0.001) 25 years after start of treatment, mean change 12.3% (95% CI 10.5 to 14.1). The mean Cobb angle at the present follow up study was 40° in both surgically and brace treated patients. The present results of lung volumes did not correlate with pretreatment or post-treatment Cobb angles or smoking habits. CONCLUSIONS Patients treated by posterior fusion or a brace gradually increase their pulmonary function up to 25 years after treatment. Smoking and curve size are not risk factors for reduced pulmonary function.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Thoracic Society</pub><pmid>11312408</pmid><doi>10.1136/thorax.56.5.388</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adolescent
adolescent idiopathic scoliosis
Age
Analysis
Back surgery
Biological and medical sciences
Braces
Child
Complications and side effects
Dyspnea
Dyspnea - etiology
etiology
Female
Follow-Up Studies
Forced Expiratory Volume
Forced Expiratory Volume - physiology
Humans
long term outcome
Lung
Lung - physiology
Male
Medical sciences
Original
Orthopedic surgery
Orthopedics
Ortopedi
Ostomy
Outcome and process assessment (Health Care)
Patients
Pediatric respiratory diseases
physiology
physiopathology
pulmonary function
Pulmonary function tests
Questionnaires
Respiratory failure
Respiratory insufficiency
Risk factors
Scoliosis
Scoliosis - physiopathology
Scoliosis - surgery
Smoking
Smoking - physiopathology
surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Vital Capacity
Vital Capacity - physiology
title Pulmonary function in adolescent idiopathic scoliosis: a 25 year follow up after surgery or start of brace treatment
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