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Value of preoperative pulmonary function test in flaccid neuromuscular scoliosis surgery

 Hyon Su Chong  ;  Eun Su Moon  ;  Jin Oh Park  ;  Do Yeon Kim  ;  Phillip Anthony B. Kho  ;  Hwan Mo Lee  ;  Sung Hwan Moon  ;  Yong Sang Kim  ;  Hak Sun Kim 
 SPINE, Vol.36(21) : 1391-1394, 2011 
Journal Title
Issue Date
Adolescent ; Adult ; Analysis of Variance ; Chi-Square Distribution ; Child ; Child, Preschool ; Female ; Forced Expiratory Volume ; Humans ; Lung/physiopathology* ; Lung Diseases/etiology* ; Lung Diseases/physiopathology ; Lung Diseases/therapy ; Male ; Neuromuscular Diseases/complications ; Neuromuscular Diseases/physiopathology ; Neuromuscular Diseases/surgery* ; Orthopedic Procedures/adverse effects* ; Patient Selection ; Pneumonia/etiology ; Pneumonia/physiopathology ; Pneumothorax/etiology ; Pneumothorax/physiopathology ; Preoperative Care ; Pulmonary Atelectasis/etiology ; Pulmonary Atelectasis/physiopathology ; Republic of Korea ; Respiration, Artificial ; Respiratory Function Tests* ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Scoliosis/etiology ; Scoliosis/physiopathology ; Scoliosis/surgery* ; Time Factors ; Treatment Outcome ; Vital Capacity ; Young Adult
neuromuscular scoliosis ; pulmonary complications ; pulmonary function test
OBJECTIVE: To evaluate the prognostic value of preoperative pulmonary function test (PFT) for postoperative pulmonary complications and to identify the operability associated with severely decreased forced vital capacity (FVC) (<30%) status in flaccid neuromuscular scoliosis. SUMMARY OF BACKGROUND DATA: The preoperative PFT, especially more than 30% FVC, is known as a critical factor for the operability of flaccid neuromuscular scoliosis. But only one study reported that patients with pre-existing respiratory failure on nocturnal noninvasive ventilation can undergo an operation for deformity correction without mortality and severe complications. METHODS: A total of 74 patients (45 male and 29 female) presented with flaccid neuromuscular scoliosis. For all patients, preoperative PFTs were evaluated and subdivided into three groups (<30% FVC, 30%-50% FVC, and >50% FVC). Then postoperative pulmonary complications, pneumothorax, pneumonia, atelectasis, prolonged ventilator care in the intensive care unit (more than 72 hours), and postoperative tracheostomy were evaluated. RESULTS: Among these patients, 59 had muscular dystrophy; 5, spinal muscular atrophy; 2, cerebral palsy; and 8, others. The mean age at surgery was 16.8 years (range, 5-32 years). The mean preoperative Cobb angle was 54.6° (16°-135°). The overall postoperative pulmonary complication rate was 31% (23 complications in 74 patients). The less than 30% FVC group had 6 complications among 18 patients; the 30% to 50% FVC group had 7 complications among 18 patients; and the more than 50% FVC group had 10 complications among 38 patients. There were no deaths during the perioperative period. There is no statistical difference between the three groups (P = 0.6195). CONCLUSION: Patients with flaccid neuromuscular scoliosis can undergo an operation for deformity correction regardless of the severely decreased pulmonary function.
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1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Yeon(김도연)
Kim, Hak Sun(김학선) ORCID logo https://orcid.org/0000-0002-8330-4688
Moon, Seong Hwan(문성환)
Moon, Eun Su(문은수)
Park, Jin Oh(박진오)
Lee, Hwan Mo(이환모) ORCID logo https://orcid.org/0000-0002-5405-3832
Chong, Hyon Su(정현수)
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