Introduction: The effect of surgical correction on pulmonary function of adult spinal deformity patients is unknown. The purpose of this study was to determine if a correlation exists between curve magnitude, deformity correction and postoperative pulmonary function (PFTs) following adult spinal deformity surgery.
Methods: We prospectively collected PFTs on 76 adult deformity patients (70F, 6M, avg age 41.2) undergoing primary surgical treatment for idiopathic scoliosis at a single institution and followed them for 2 years (avg 2.93). Radiographs for all pts were analyzed for main thoracic (MT) and sagittal T5-T12 (Sag) curve magnitude/correction.
Results: For all patients, there was a significant change in MT Cobb correction from 53.2 to 20.8 deg (avg -32.5 deg, p=0.00), Sag Cobb from 35.3 to 28.8 deg (avg -6.50 deg, p=0.00), and a significant decline in absolute and %pred PFTs after surgery, with %pred FEV1 and %pred FVC decreasing 5.86% (p=0.00) and 3.54% (p=0.01), respectively. We found pre-op MT curve magnitude significantly correlated (moderate, negative) with pre-op absolute and %predicted PFTs (r=0.364 to 0.506; p=0.001). The amount of MT deformity correction was also significantly correlated (weak, negative) with changes in %pred FEV1 and %pred FVC [change%pred FEV (r=-0.238, p=0.04); change%pred FVC (r=-0.249, p=0.03)], and there was no significant relationship between Sag deformity correction and PFTs.
Conclusions: Pre-op MT curve magnitude in adult spinal deformity patients negatively correlated with pre-op pulmonary function (PFTs). There was also a negative correlation between MT deformity correction and %pred PFT change, which suggests that greater MT curve correction may result in significantly less decline in pulmonary function than smaller curve corrections.
Patient Care: Our study suggests greater curve correction for adult spinal deformity may improve pulmonary function.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the importance of pulmonary function test in patients with spinal deformity, 2) Discuss the correlation between pre-operative major thoracic cobb angle and pulmonary function