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Six-year follow-up study on the effect of combined anterior and posterior spinal fusion on lung function and quality of life in young people with adolescent idiopathic scoliosis
  1. D S Urquhart1,
  2. S Gallella1,
  3. D Gidaris1,
  4. E Brady2,
  5. S Blacklock1,
  6. A I Tsirikos2
  1. 1Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK
  2. 2Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK
  1. Correspondence to Dr Don Urquhart, Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh EH9 1LF., UK; don.urquhart{at}nhslothian.scot.nhs.uk

Abstract

Objectives The effects of spinal surgery on lung function and quality of life (QoL) are important patient outcomes. Long-term follow-up of lung function and QoL in those undergoing combined anterior and posterior spinal fusion (A/PSF) for adolescent idiopathic scoliosis (AIS) is poorly documented with only one study extending beyond 2 years, though available evidence points to a decrement in lung function. Our study evaluated long-term change in lung function and QoL following A/PSF for AIS.

Design Prospective cohort study.

Patients Patients with AIS.

Setting Tertiary paediatric respiratory centre and national spinal service.

Design Spirometry was performed along with QoL (Scoliosis Research Society-22 (SRS-22) questionnaire). Paired t test and one-way analysis of variance were used to compare pre-A/PSF and post-A/PSF data.

Results Data were available for 12 patients (9 female) who underwent A/PSF at mean 13.8 (range 11.8–15) years. Mean follow-up was undertaken 5.8 (range 4.1–6.8) years postoperatively. Height increased from mean (SD) 169 (9) cm preoperatively to 175 (5) cm at follow-up (p<0.01). Scoliosis corrected from 100 (15)° to 29 (11)° (p<0.001). Mean (SD) forced expiratory volume in 1 s was −3.4 (1.4) z scores preoperatively versus −3.3 (1) z scores postoperatively (p=0.85); and forced vital capacity was −3.4 (1.7) ) z scores pre-A/PSF and −3.4 (1.1) z scores post-A/PSF (p=0.83). SRS-22 scores improved mean (SD) of 3.6 (0.3) preoperatively to 4.2 (0.3) at 2 years postoperatively, and 4.4 (0.4) at 6 year follow-up (p<0.001, analysis of variance). High patient satisfaction rates (4.8 (0.3)) were recorded. No correlation was noted between changes in forced expiratory volume in 1 s (r=−0.15, p=0.63) or forced vital capacity (r=−0.12, p=0.71) and change in long-term SRS-22 score.

Conclusions Long-term follow-up of patients with AIS suggests no deficit in pulmonary function, while QoL shows incremental improvement and patient satisfaction is high over 6 years after A/PSF.

  • Respiratory
  • Qualitative Research
  • Adolescent Health
  • Scoliosis
  • Spinal Surgery

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