SHORT-TERM EFFECTS OF THORACOSCOPIC ANTERIOR SPINE RELEASE COMBINED WITH POSTERIOR CORRECTION ON PULMONARY FUNCTION IN PATIENTS WITH IDIOPATHIC SCOLIOSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Limin , SONG Yueming , ZHOU Zhongjie , LI Qian , ZHOU Chunguang.

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.;

Corresponding author：

Keywords：

Thoracoscope， Idiopathic scoliosis， Pulmonary function

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【Abstract】 Objective To study the short-term effects of thoracoscopic anterior spine release combined with posterior correction on the pulmonary function in patients with idiopathic scoliosis (IS). Methods Between April 2004 and June 2008, 21 cases of IS underwent thoracoscopic anterior spine release combined with posterior correction. There were 9 males and 12 females with a mean age of 15.6 years (range, 12 to 24 years). Of 11 patients, 2 had left protrusion deformity and 19 had right protrusion deformity, including 12 cases of Lenke type I and 9 cases of Lenke type II, with an average coronal Cobb’s angle of 79.6° (range, 65-125°). The disease duration ranged from 1 year and 6 months to 9 years (mean, 2.5 years). The results of pulmonary function tests (PFTs) were compared between pre-operation and postoperative 6th month, including lung capacity, ventilation function, and thoracic compliance. Results The opening time of the chest was 90 to 150 minutes (mean, 127 minutes) at the thoracoscopic anterior spine release and all incisions healed by first intention with no chest cavity infection. All the patients were followed up from 6 to 36 months (mean, 13.5 months). The average coronal Cobb’s angle was 43.7° (range, 36-75°) at 1 week after posterior correction. At 6 months after operation, the vital capacity and total capacity were significantly increased (P lt; 0.05), but no significant change was observed in the percentage of actual value and expected one when compared with pre-operation (P gt; 0.05). The functional residual capacity and the percentage of actual value and expected one of residual volume was significantly decreased when compared with those at pre-operation (P lt; 0.05). The forced expiratory volume in one second (FEV1) and FEV1/FEV were not significantly improved (P gt; 0.05) , but the maximum ventilatory volume was significantly increased when compared with the preoperative value (P lt; 0.05). In addition, the Raw Total, Raw Insp, and Raw Exp decreased significantly after operation (P lt; 0.05). Conclusion Although the thoracoscopic anterior spine release combined with posterior correction might disturb the function of the thoracic cavity, the PFTs of the patients could be improved at different aspects because of the shape changes of the thoracic cavity, and the pulmonary function still needed further observation.

Citation： LIU Limin,SONG Yueming,ZHOU Zhongjie,LI Qian,ZHOU Chunguang.. SHORT-TERM EFFECTS OF THORACOSCOPIC ANTERIOR SPINE RELEASE COMBINED WITH POSTERIOR CORRECTION ON PULMONARY FUNCTION IN PATIENTS WITH IDIOPATHIC SCOLIOSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(1): 70-73. doi: Copy

1.	scoliosis. Spine (Phila Pa 1976), 2011, 36(14): 1096-1102.
2.	idiopathic scoliosis relative to the surgical procedure: a 10-year follow-up analysis. Spine (Phila Pa 1976), 2011, 36(20): 1665-1672.
3.	spinal fusion compared with posterior spinal fusion with thoracic.
4.	pedicle screws for thoracic adolescent idiopathic scoliosis. J Bone Joint Surg (Am), 2009, 91(2): 398-408.
5.	in male versus female adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2007, 32(5): 544-549.
6.	after surgical treatment of idiopathic scoliosis. Coll Antropol, 2009, 33 Suppl 2: 145-152.
7.	versus open approaches. Spine (Phila Pa 1976), 2005, 30(9): 1058-1063.
8.	idiopathic scoliosis. J Spinal Disord Tech, 2009, 22(8): 551-558.
9.	of thoracoscopic anterior release using the fulcrum-bending radiograph: a report of five cases. Eur Spine J, 2006, 15 Suppl 5: 578-582.
10.	pulmonary function less than thoracotomy at 2 years postsurgery. Spine (Phlia Pa 1976), 2007, 32(4): 453-458.
11.	scoliosis. Acta Orthop Belg, 2010, 76(5): 681-683.
12.	in the surgical treatment of adolescent idiopathic scoliosis. J Spinal Disord Tech, 2010, 23(8): e63-69.
13.	Johnston CE, Richards BS, Sucato DJ, et al. Correlation of preoperative deformity magnitude and pulmonary function tests in adolescent idiopathic.
14.	Gitelman Y, Lenke LG, Bridwell KH, et al. Pulmonary function in adolescent.
15.	Koumbourlis AC. Scoliosis and the respiratory system. Paediatr Respir Rev, 2006, 7(2): 152-160.
16.	Lonner BS, Auerbach JD, Estreicher M, et al. Video-assisted thoracoscopic.
17.	Newton PO, Upasani VV, Lhamby J, et al. Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. J Bone Joint Surg (Am), 2009, 91 Suppl 2: 233-248.
18.	Sucato DJ, Erken YH, Davis S, et al. Prone thoracoscopic release does not adversely affect pulmonary function when added to a posterior spinal fusion for severe spine deformity. Spine (Phlia Pa 1976), 2009, 34(8): 771-778.
19.	Vedantam R, Lenke LG, Bridwell KH, et al. A prospective evaluation of pulmonary function in patients with adolescent idiopathic scoliosis relative to the surgical approach used for spinal arthrodesis. Spine (Phlia Pa 1976), 2000, 25(1): 82-90.
20.	Yaszay B, Jazayeri R, Lonner B. The effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis. J Spinal Disord Tech, 2009, 22(4): 278-283.
21.	Marks M, Petcharaporn M, Betz RR, et al. Outcomes of surgical treatment.
22.	Smiljani? I, Kovac V, Cimi? M. Changes in pulmonary functional parameters.
23.	Faro FD, Marks MC, Newton PO, et al. Perioperative changes in pulmonary function after anterior scoliosis instrumentation: thoracoscopic.
24.	Lonner BS, Auerbach JD, Estreicher MB, et al. Pulmonary function changes after various anterior approaches in the treatment of adolescent.
25.	Cheung KM, LU DS, Zhang H, et al. In vivo demonstration of the effectiveness.
26.	Kishan S, Bastrom T, Betz RR, et al. Thoracoscopic scoliosis surgery affects.
27.	Saleh AM, Masry MA, West RM, et al. Improved pulmonary function after concave rib resection and posterior instrumentation for idiopathic.
28.	周春光, 刘立岷, 宋跃明, 等. 重度僵硬性特发性脊柱侧凸患者术后肺功能变化. 中国修复重建外科杂志, 2010, 24(1): 23-26.
29.	Verma K, Lonner BS, Kean KE, et al. Maximal pulmonary recovery after spinal fusion for adolescent idiopathic scoliosis: how do anterior approaches compare? Spine (Phlia Pa 1976), 2011, 36(14): 1086-1095.
30.	Greggi T, Bakaloudis G, Fusaro I, et al. Pulmonary function after thoracoplasty.

1. scoliosis. Spine (Phila Pa 1976), 2011, 36(14): 1096-1102.
2. idiopathic scoliosis relative to the surgical procedure: a 10-year follow-up analysis. Spine (Phila Pa 1976), 2011, 36(20): 1665-1672.
3. spinal fusion compared with posterior spinal fusion with thoracic.
4. pedicle screws for thoracic adolescent idiopathic scoliosis. J Bone Joint Surg (Am), 2009, 91(2): 398-408.
5. in male versus female adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976), 2007, 32(5): 544-549.
6. after surgical treatment of idiopathic scoliosis. Coll Antropol, 2009, 33 Suppl 2: 145-152.
7. versus open approaches. Spine (Phila Pa 1976), 2005, 30(9): 1058-1063.
8. idiopathic scoliosis. J Spinal Disord Tech, 2009, 22(8): 551-558.
9. of thoracoscopic anterior release using the fulcrum-bending radiograph: a report of five cases. Eur Spine J, 2006, 15 Suppl 5: 578-582.
10. pulmonary function less than thoracotomy at 2 years postsurgery. Spine (Phlia Pa 1976), 2007, 32(4): 453-458.
11. scoliosis. Acta Orthop Belg, 2010, 76(5): 681-683.
12. in the surgical treatment of adolescent idiopathic scoliosis. J Spinal Disord Tech, 2010, 23(8): e63-69.
13. Johnston CE, Richards BS, Sucato DJ, et al. Correlation of preoperative deformity magnitude and pulmonary function tests in adolescent idiopathic.
14. Gitelman Y, Lenke LG, Bridwell KH, et al. Pulmonary function in adolescent.
15. Koumbourlis AC. Scoliosis and the respiratory system. Paediatr Respir Rev, 2006, 7(2): 152-160.
16. Lonner BS, Auerbach JD, Estreicher M, et al. Video-assisted thoracoscopic.
17. Newton PO, Upasani VV, Lhamby J, et al. Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. J Bone Joint Surg (Am), 2009, 91 Suppl 2: 233-248.
18. Sucato DJ, Erken YH, Davis S, et al. Prone thoracoscopic release does not adversely affect pulmonary function when added to a posterior spinal fusion for severe spine deformity. Spine (Phlia Pa 1976), 2009, 34(8): 771-778.
19. Vedantam R, Lenke LG, Bridwell KH, et al. A prospective evaluation of pulmonary function in patients with adolescent idiopathic scoliosis relative to the surgical approach used for spinal arthrodesis. Spine (Phlia Pa 1976), 2000, 25(1): 82-90.
20. Yaszay B, Jazayeri R, Lonner B. The effect of surgical approaches on pulmonary function in adolescent idiopathic scoliosis. J Spinal Disord Tech, 2009, 22(4): 278-283.
21. Marks M, Petcharaporn M, Betz RR, et al. Outcomes of surgical treatment.
22. Smiljani? I, Kovac V, Cimi? M. Changes in pulmonary functional parameters.
23. Faro FD, Marks MC, Newton PO, et al. Perioperative changes in pulmonary function after anterior scoliosis instrumentation: thoracoscopic.
24. Lonner BS, Auerbach JD, Estreicher MB, et al. Pulmonary function changes after various anterior approaches in the treatment of adolescent.
25. Cheung KM, LU DS, Zhang H, et al. In vivo demonstration of the effectiveness.
26. Kishan S, Bastrom T, Betz RR, et al. Thoracoscopic scoliosis surgery affects.
27. Saleh AM, Masry MA, West RM, et al. Improved pulmonary function after concave rib resection and posterior instrumentation for idiopathic.
28. 周春光, 刘立岷, 宋跃明, 等. 重度僵硬性特发性脊柱侧凸患者术后肺功能变化. 中国修复重建外科杂志, 2010, 24(1): 23-26.
29. Verma K, Lonner BS, Kean KE, et al. Maximal pulmonary recovery after spinal fusion for adolescent idiopathic scoliosis: how do anterior approaches compare? Spine (Phlia Pa 1976), 2011, 36(14): 1086-1095.
30. Greggi T, Bakaloudis G, Fusaro I, et al. Pulmonary function after thoracoplasty.

Chinese Journal of Reparative and Reconstructive Surgery

SHORT-TERM EFFECTS OF THORACOSCOPIC ANTERIOR SPINE RELEASE COMBINED WITH POSTERIOR CORRECTION ON PULMONARY FUNCTION IN PATIENTS WITH IDIOPATHIC SCOLIOSIS

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