The Journal of Bone and Joint Surgery, Vol 64, Issue 2 242-248, Copyright © 1982 by Journal of Bone and Joint Surgery, Inc
Pulmonary function before and after surgical correction of scoliosis
K Kumano and N Tsuyama
We compared the preoperative and postoperative pulmonary function of
thirty-one scoliotic patients ranging in age from nine to twenty-five
years. The mean postoperative follow-up period was three years and eight
months. Twenty patients were treated by a posterior procedure with
Harrington instrumentation. At more than two years postoperatively a
significant improvement in the pulmonary function was noted, particularly
in patients with a preoperative curve of less than 90 degrees (Cobb angle)
and in those in whom the correction was greater than 30 per cent. The
remaining eleven patients were treated by an anterior procedure, primarily
a Dwyer operation, with or without posterior Harrington instrumentation.
These patients manifested no remarkable improvement in pulmonary function
more than two years after surgery; three patients showed deterioration. The
results of tests performed less than two years postoperatively showed no
improvement in pulmonary function, irrespective of the types of assessments
used. We attribute our long-term improvements to a shortening of the
postoperative period of plaster-cast immobilization and to the use of a
plastic corset which allowed relatively free chest motion. We suggest that
the Dwyer operation should be restricted to patients with a severe spinal
deformity.
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