Nanci Yuan, MD
Publication Details
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The Effect of Scoliosis Surgery on Lung Function in the Immediate Post-operative Period.
SPINE. 2005(Accepted October 2004, in press for October 2005) Objective. The number of pediatric scoliosis surgeries is increasing each year due to recent advances in spinal instrumentation, surgical techniques, and improved peri-operative monitoring. Pulmonary function decreases immediately following scoliosis surgery, but the extent of this decrease is not well documented in pediatric patients. In order to use pre-operative pulmonary function tests (PFT) to assess the risk of post-operative complications, knowledge of the post-operative decline in PFT is necessary. The objective of this study was to determine the immediate change in PFT in children following scoliosis surgery. Methods. We measured pre-operative PFT and daily post-operative PFT in 24 children who had scoliosis surgery (age 12.7 + 2.7 [SD] years) from January 2002 to June 2003. There were 10 male patients and 14 female patients. 2 (8%) patients had congenital scoliosis, 11 (46%) patients had idiopathic scoliosis, 9 (38%) patients had scoliosis due to a neuromuscular disease, and 2 (8%) patients had kyphoscoliosis. 15 (62%) patients had PSF, 5 (21%) patients had ASF, and 4 (17%) patients had both ASF and PSF performed. PFT parameters (FEV1, FVC, FEV1/FVC, and FEV25-75%) were measured pre-operatively, and daily post-operatively by bedside spirometry until hospital discharge. Results. PFT declined up to 60% post-operatively. The PFT nadir is at 3 days. PFT values remained significantly decreased at one week, with values at about ½ of pre-operative baseline. No patient required post-operative MV >3 days. There was no statistical significance between the degree of decline in PFT with etiology of neither the scoliosis nor the type of surgery performed.
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