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Value of preoperative pulmonary function test in flaccid neuromuscular scoliosis surgery

Authors
 Hyon Su Chong ; Eun Su Moon ; Hak Sun Kim ; Yong Sang Kim ; Sung Hwan Moon ; Hwan Mo Lee ; Phillip Anthony B. Kho ; Do Yeon Kim ; Jin Oh Park 
Citation
 Spine, Vol.36(21) : E1391~E1394, 2011 
Journal Title
 Spine 
ISSN
 0362-2436 
Issue Date
2011
Abstract
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93991
DOI
10.1097/BRS.0b013e31820cd489
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Orthopedic Surgery
Yonsei Authors
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Link
 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00007632-201110010-00022&LSLINK=80&D=ovft
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