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Evaluation on Changes and Significance of Lung Capacity in Patients with Severe Spinal Deformities Relative to Posterior Surgical Approach Used for Correction

Author: ZhaoWei
Tutor: JieJingMing
School: Kunming Medical College
Course: Surgery
Keywords: Kyphoscoliosis Correction Spinal fusion Multi-slice spiral CT Lung capacity
CLC: R687.3
Type: Master's thesis
Year: 2011
Downloads: 12
Quote: 0
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Abstract

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.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
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