Open Access Research

Pulmonary function after less invasive anterior instrumentation and fusion for idiopathic thoracic scoliosis

Geertje C Huitema1*, Rob C Jansen2, Edward Dompeling3, Paul Willems2, Ilona Punt4 and Lodewijk W van Rhijn2*

Author Affiliations

1 Department of Orthopedic Surgery, Westfriesgasthuis, Hoorn, NH, The Netherlands

2 Department of Orthopedic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands

3 Department of Paediatric Pulmonology, Maastricht University Medical Centre, Maastricht, The Netherlands

4 Research School CAPHRI, Maastricht University, Maastricht, The Netherlands

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Scoliosis 2013, 8:14  doi:10.1186/1748-7161-8-14

Published: 21 August 2013

Abstract

Purpose

Standard thoracotomy for anterior instrumentation and fusion of the thoracic spine in idiopathic scoliosis may have detrimental effects on pulmonary function. In this study we describe a less invasive anterior surgical technique and show the pre- and postoperative pulmonary function with a minimum follow-up of 2 years.

Methods

Twenty patients with Lenke type 1 adolescent thoracic idiopathic scoliosis were treated with anterior spinal fusion and instrumentation. The mean preoperative Cobb angle of the thoracic curve was 53° ± 5.8. Pulmonary function tests (PFT) and radiographic evaluation was performed.

Results

The mean postoperative correction in Cobb angle of the thoracic curve was 27° ± 8.2 (49%).

The mean preoperative FEV1 was 2.81 ± 0.43 L, which increased to 3.14 ± 0.50 L at 2 years postoperatively (P = 0.000). The mean FEV1% did not change (89.60 ± 7.49% preoperatively, versus 90.53 ± 5.95% at 2 years follow-up, P = 0.467). The TLC increased from 4.62 ± 0.62 L preoperatively to 5.17 ± 0.63 L at 2 years follow-up (P = 0.000). The FEV1% at two years of follow-up improved to 104% of the FEV1% predicted value. The FEV1 improved to 97% of the FEV1 predicted value.

Conclusion

Anterior spinal fusion for idiopathic scoliosis by means of a minimal open thoracotomy proved to be a safe surgical technique that resulted in an improvement of pulmonary function. Our results are similar to those of thoracoscopic procedures reported in literature.

Keywords:
Adolescent idiopathic scoliosis; Pulmonary function tests; Anterior fusion; Anterior instrumentation