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• W2969369511 abstract "BACKGROUND CONTEXT Surgical treatment of spinal deformity based on the severity of curves and with a view to improve physical performance and respiratory function. However, there was still controversial in the correlation of deformity correction rate and pulmonary function tests (PFTs) change in AIS, and no more study focused on patients with >90° scoliotic curves. PURPOSE To evaluate the relationships of Cobb angle and PFTs change in severe scoliosis with RI and underwent posterior vertebral column resection (PVCR). STUDY DESIGN/SETTING A retrospective study. PATIENT SAMPLE This study enrolled severe scoliosis (Cobb angle>90°) with moderate or severe RI underwent PVCR in one center from 2004 to 2016. Exclude criteria including neuromuscular or syndromic scoliosis. OUTCOME MEASURES PFTs values, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were used as both absolute values and percent-predicted values. Radiographic measurements of deformities included Cobb magnitude of major curve and deformity morphological classification. METHODS PFTs and radiographic data had been calculated preop and at 2yrs after PVCR. Patients were grouped according scoliosis angle (90°-130° vs >130°), age (pediatric vs adult), with >90° kyphosis or not, preop RI levels (FVC% 41-60%/moderate RI, 0-40%/severe RI). Pearson's correlation coefficients (r) and two-sample t test were used. RESULTS A total of 62 cases (29 male/33 female, mean age 18.9Yr) was enrolled. Preoperatively, the average scoliotic angle was 118.5, with apex T4-10(54, 87.1%) and T11-L1(8, 12.9%). Respiratory impairments were restrictive (FVC=1.409L, FVC%=40.85%; FEV1=1.283L, FEV1%=44.12%), and 28(45.2%) had FVC%<40%. There was no correlation between the preoperative major curve Cobb angle and FVC/FVC% values, in whole or in angle, age, kypho, and RI levels subgroups. However, deformity as long curve have more severe PFTs impairment than others. When 2 years after PVCR, average FVC/FVC% were increased to 1.801L and 49.4%, with residual Cobb angle 43.7. In patients with preop FVC% 41-60%, there was a correction between Cobb angle change and PFTs improvement (FVC, r=0.523, p=0.018; FVC%, r=0.491, p=0.048), but no correction in preoperative FVC%<40% group. However, there was no correlation between correction rate and PFTs change, in whole or in subgroups. Preop FVC% values showed strong negative correction with 2 yrs PFTs improvement (FVC, r=-0.488, p=0.013; FVC%, r=-0.612, p=0.000). Patients with residual angle >60 had less improvement of PFTs than angle <60 (FVC increased, 0.289L VS 0.414L, p=0.042), but there was no difference between residual angle <40 and 40-60 groups. CONCLUSIONS Severe scoliosis may reveal severe respiratory dysfunction, but preoperative PFTs values did not related to Cobb angle. Age of deformity onset, illegible etiological factors, and lung infection may play an important role for PFTs impairment. After PVCR, most of patients had significant PFTs improvement, and correlated with Cobb angle change in patients with preop moderate respiratory impairment. Much lower of preoperative FVC%, more increase PFTs at 2 years postoperative. But, residual angle 60° or less did not ultimately influence PFTs change. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. Surgical treatment of spinal deformity based on the severity of curves and with a view to improve physical performance and respiratory function. However, there was still controversial in the correlation of deformity correction rate and pulmonary function tests (PFTs) change in AIS, and no more study focused on patients with >90° scoliotic curves. To evaluate the relationships of Cobb angle and PFTs change in severe scoliosis with RI and underwent posterior vertebral column resection (PVCR). A retrospective study. This study enrolled severe scoliosis (Cobb angle>90°) with moderate or severe RI underwent PVCR in one center from 2004 to 2016. Exclude criteria including neuromuscular or syndromic scoliosis. PFTs values, forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were used as both absolute values and percent-predicted values. Radiographic measurements of deformities included Cobb magnitude of major curve and deformity morphological classification. PFTs and radiographic data had been calculated preop and at 2yrs after PVCR. Patients were grouped according scoliosis angle (90°-130° vs >130°), age (pediatric vs adult), with >90° kyphosis or not, preop RI levels (FVC% 41-60%/moderate RI, 0-40%/severe RI). Pearson's correlation coefficients (r) and two-sample t test were used. A total of 62 cases (29 male/33 female, mean age 18.9Yr) was enrolled. Preoperatively, the average scoliotic angle was 118.5, with apex T4-10(54, 87.1%) and T11-L1(8, 12.9%). Respiratory impairments were restrictive (FVC=1.409L, FVC%=40.85%; FEV1=1.283L, FEV1%=44.12%), and 28(45.2%) had FVC%<40%. There was no correlation between the preoperative major curve Cobb angle and FVC/FVC% values, in whole or in angle, age, kypho, and RI levels subgroups. However, deformity as long curve have more severe PFTs impairment than others. When 2 years after PVCR, average FVC/FVC% were increased to 1.801L and 49.4%, with residual Cobb angle 43.7. In patients with preop FVC% 41-60%, there was a correction between Cobb angle change and PFTs improvement (FVC, r=0.523, p=0.018; FVC%, r=0.491, p=0.048), but no correction in preoperative FVC%<40% group. However, there was no correlation between correction rate and PFTs change, in whole or in subgroups. Preop FVC% values showed strong negative correction with 2 yrs PFTs improvement (FVC, r=-0.488, p=0.013; FVC%, r=-0.612, p=0.000). Patients with residual angle >60 had less improvement of PFTs than angle <60 (FVC increased, 0.289L VS 0.414L, p=0.042), but there was no difference between residual angle <40 and 40-60 groups. Severe scoliosis may reveal severe respiratory dysfunction, but preoperative PFTs values did not related to Cobb angle. Age of deformity onset, illegible etiological factors, and lung infection may play an important role for PFTs impairment. After PVCR, most of patients had significant PFTs improvement, and correlated with Cobb angle change in patients with preop moderate respiratory impairment. Much lower of preoperative FVC%, more increase PFTs at 2 years postoperative. But, residual angle 60° or less did not ultimately influence PFTs change." @default.
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• W2969369511 date "2019-09-01" @default.
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• W2969369511 title "316. Is there a correlation between Cobb angle and pulmonary function tests in severe scoliosis patients with respiratory impairment and treated by posterior vertebral column resection?" @default.
• W2969369511 doi "https://doi.org/10.1016/j.spinee.2019.05.333" @default.
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