Pulmonary Function Change And Causes After Treated With PVCR And SPPC In Rigid Spinal Scoliosis Or Kyphosis Accompany With Ventilation Dysfunction

[Objective] To study the different time pulmonary function change and cause after posterior vertebral column resection and single posterior pedicle screw correction treat with rigid spinal scoliosis or kyphosis accompany with ventilation dysfunction.[Method] Retrospective analysis posterior operation method treated 31 spinal scoliosis or kyphosis patients with ventilation dysfunction, in thoracic or thoracolumbar segments. Treated with PVCR 26 cases(Table 1), there were 15 males, 11 females, the average age 28.8(11-45)year. Treated with SPPC in 5 patients(Table 2), 3 males, 2 females, the average age 28.6 (15-41) year. All the adolescence patients are not AIS even rigid deformity, all adult patients have low back pain. Before operation the neurological function Frankel grading, besides 3 cases is the D level other is the E level. According to the FVC and FEV1 value, all the patients are moderate ventilation dysfunctions, including 4 severe ventilation dysfunctions. All the patients treated with posterior vertebral column resection or pure pedicle screw system fixed correction.[Results] PVCR group the scoliosis cobb angle is from 83.00±34.66°correction to 30.80±19.73°and kyphosis angle is from 76.12±31.13°correction to 18.08±10.33°respectively. Correction rate achieves 65.0% and 79.1%, all patients obtain the satisfactory sagittal plane and coronal plane torso are balanced. SPPC group the scoliosis cobb angle is from 73.75±13.15°correction to 35.75±1.50°, and kyphosis angle is from 96.00±14.56°correction to 50.60±12.63°respectively. Correction rate achieves 51.5% and 47.3%. all the two groups, postoperation scoliosis and kyphosis cobb angle have remarkable statistics difference (P<0.05) to compare the preoperation. Before operation, the PVCR group FVC value 1.13±0.54L, FVC% values 28.6±15.3%, FEV1 value 1.05±0.58L FEV1% values 27.8±14.5%; change to 1.5±0.55L,31±14.5%,1.26±0.48L,29.0±13.8% respectively 1 year after the treatment; has the significance statistics difference (P<0.05), better than preoperation. Before operation, the SPPC group the FVC value 1.42±0.44L, FVC% values 40.6±15.3%, FEV1 the value 1.35±0.58L, FEV1% values 37.8±13.5%, change to 1.42±0.51L,40.4±14.5%,1.35±0.48L,36.7±13.8% respectively 1 year after the treatment; the level non-significance statistics difference (P>0.05), the same as preoperation. [Conclusion] l)Patients underwent both PVCR and SPPC showed a decline Pulmonary function at three month after surgery. 2)Done with PVCR, severe and rigid scoliosis or kyphosis patients can obtain satisfactory correction. 3) Patients underwent PVCR showed a increase Pulmonary function at one year after surgery, however, SPPC group showed a increase Pulmonary function at two years after surgery. 4) Pulmonary function increase may be related to the improvement of V/Q rate.