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Evaluation on Changes and Significance of Pulmonary Function in Patients with Adolescent Idiopathic Scoliosis Relative to the Surgical Approach Used for Spinal Arthrodesis

Author: ChenXiaoMing
Tutor: ZhangHongQi
School: Central South University
Course: Surgery
Keywords: Idiopathic scoliosis Spinal arthrodesis Orthopaedic treatment Pulmonary function
CLC: R687.3
Type: Master's thesis
Year: 2008
Downloads: 51
Quote: 0
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Abstract


Objective To evaluate prospectively, at regular intervals, the changes and the significance in pulmonary function after surgical arthrodesis of adolescent idiopathic scoliosis in a homogeneous population within 2 years relative to the surgical approach used for spinal arthrodesis.Method Since October 2003 to March 2006 , there were 85 patients of Scoliosis operated in our department ,67 Adolescent Idiopathic Scoliosis patients , chosen from 85 patients of Scoliosis, had structive thoracic and thoracic-lumbal types of adolescent idiopathic scoliosis were evaluated in the investigation, 67 patients were endivided into 3 groups depending on the surgical approach used for spinal fusion:Group 1 (n = 19) underwent a posterior spinal fusion with allogeneic bone graft; Group 2 (n = 28) underwent a posterior spinal fusion with rib resection thoracoplasty; and Group 3 (n = 20) underwent a combined anterior and posterior spinal fusion with autogenous rib graft used , respectively.All patients undergoing surgical treatment at the authors’ institution were prospectively evaluated with pulmonary function tests assessing volume (forced vital capacity FCV) and flow (forced expiratory volume in 1 second FEV1). Pulmonary functions were evaluated before surgery and after surgery at 3 months, 1 year, 2 years. Results 1)A11 groups of patients showed a significantly difference of pulmonary function contrasting 3 monthes after operation with preoperation (P < 0.05),which meaned various degree of decline. Two years after surgery,Group 1 had significantly improved pulmonary function values (P < 0.05), whereas the pulmonary function values of patients in Groups 2 and 3 had returned nearly to preoperative values(P > 0.05) . there existed negative correlation between cobb angle、kyphos angle and preoperative pulmonary function values.Conclusion 1) Patients which underwent a posterior spinal fusion with allogeneic bone graft showed a decline in pulmonary function at 3 months after surgery,their pulmonary function values at 2 years after surgery had shown an greater improvement than their values at preopration. 2) Patients ,which underwent a posterior spinal fusion with rib resection thoracoplasty or combined anterior and posterior spinal fusion with autogenous rib graft used , showed a decline in pulmonary function at 3 months after surgery also,but postoperative pulmonary function tests only returned to preoperative values at 2 years after surgery. 3) There existed negative correlation between cobb angle、kyphos angle and preoperative pulmonary function values.

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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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