Short term effect and effect on rate of lung function decline after
surgery for neuromuscular or syndromic scoliosis
Abstract
Introduction Understanding the impact of scoliosis surgery on lung
function is important for counseling patients about risks and benefits
of surgery. We prospectively compared the trends in lung function test
(LFT) results prior to and after scoliosis surgery in children with
neuromuscular diseases, or dysmorphic syndromes. We hypothesized a
stabilization. Methods We prospectively included children with
neuromuscular or syndromic scoliosis able to perform LFTs. We studied
(Forced) Vital Capacity ((F)VC), the ratio of Forced Expiratory Volume
in 1 second (FEV1) and FVC, and Peak Expiratory Flow (PEF). Preoperative
LFT results were compared with results 3-4 months after surgery. The
mean monthly change in LFT results up to 2 years after surgery was
compared with the preoperative natural history using linear mixed
effects models. Results We included 43 patients. No significant change
was observed in absolute values of (F)VC, FEV1/FVC and PEF prior to and
after surgery. Median standardized VC, FVC and PEF decreased
significantly after surgery from 59 to 58%, 60 to 51% and 61 to 53%
respectively. The monthly rate of change in FVC was -0.13 % (95% CI
-0.42 to 0.17) prior to surgery and -0.20% (95% CI -0.42 to 0.03)
after surgery, mean difference -0.07 (95% CI -0.46 to 0.31; p=0.36).
Conclusion No stabilization of lung function 3-4 months after scoliosis
surgery was observed in children with neuromuscular and syndromic
scoliosis with restrictive lung function disease. The effect of surgery
on the rate of lung function decline remains inconclusive.