Evaluation On Changes And Significance Of Lung Capacity In Patients With Severe Spinal Deformities Relative To Posterior Surgical Approach Used For Correction

Objective To evaluate prospectively,at regular intervals,the changes and the significance in lung capacity after surgical corrected of severe spinal deformities in a homogeneous population within 1 years.Methods Since 2009 to 2010,there were 29 patints(13male,16female) of severe spinal deformities,had structive right thoracic curves and right thoracic-lumbal curves,operated in our department,were evaluated in the investigation.29 patients were endivided into 2 groups depending on the different rigid and surgical way used for spinal fusion:Groupl(n=14)underwent a posterior vertebral column resection with allogeneic bone graft,the average age 17.5 (12-25) year;Group 2 (n=15)underwent a single posterior pediele screw correction with allogeneic bone graft, the average age 18.0 (14～26) year. The total lung was respectively scanned and X-ray film were evaluated before surgery,after surgery and at 6 months,1 year.Recorded left,right, total lung capacity,Cobb angle and kyphosis angle.Results The convex-side,concave-side and total lung capacity of group 1,showed a significantly difference contrasting after operation with preoperation(p< 0.05),which meaned various degree of decline;but no significantly differenc of convex-side,concave-side and total lung capacity after surgery one year. The group 2 patient's concave-side lung capacity values had a significantly decline between preoperative values(p<0.05);but convex-side and total lung capacity had no significantly difference. The group 2 patient's convex-side,concave-side and total lung capacity values returned nearly to preoperative values after operation one year.There existed negative correlation between cobb angle,kyphosis angle and preoperative lung capacity values(p<0.05).Group 1 the scoliosis cobb angle is from 104.1±25.1°correction to 39.5±16.5°,and kyphosis angle is from 72.3±34.9°correction to 24.7±14.4°repectively.Correction rate is 0.634 and 0.687.All patients obtain the satisfactory sagittal plane and coronal plane torso are balanced. Group 2 the scoliosis cobb angle is from 76.1±10.7°correction to 31.4±11.3°and kyphosis angle is from 49.5±14.4°correction to 27.3±6.9°repectively.Correction rate is 0.591 and 0.427. The two groups,postoperation scoliosis cobb angle and kyphosis angle have ststistics difference to compare the preoperation (p<0.05)Conclusion 1)Patients which underwent a posterior vertebral column resection with allogeneic bone graft showed a decline in lung capacity after surgery,their lung capacity values at 1 year after surgery had shown no significantly differenc of lung capacity than their values at preopration.2)Patients,which underwent a single posterior correction,showed a decline in lung capacity, especially convex;lung capacity values returned nearly to preoperative values after operation 1 year.3)There existed negative correlation between cobb angle,kyphosis angle and preoperative lung capacity.