Effect of thoracoplasty on pulmonary function and esthetics in patients with adolescent idiopathic scoliosis

Abstract

Purpose To evaluate pulmonary function and clinical and functional outcomes in patients with adolescent idiopathic scoliosis (AIS) treated with posterior spinal fusion and costoplasty. Materials and methods We evaluated prospectively 18 consecutive patients with thoracic AIS treated with instrumented posterior spinal fusion with concomitant costoplasty with a 2 years follow-up. Pulmonary function was assessed by forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1) before surgery, and one and two years after surgery. We used the SRS-22 questionnaire to assess the clinical outcomes before surgery and two years after surgery. Results Average absolute preoperative FVC was 2.63 L (theoretical predictive value FVC: 77.15%) while FEV 1 was 2.29 (theoretical predictive value FEV 1: 79.46%). At one year postsurgery, mean values of FVC and FEV 1 were, respectively, 2.77 and 2.48 (theoretical predictive value FVC: 79.8% and FEV 1: 85.2%). At two years postsurgery, mean value of FVC was 2.86 L and 2.64L for FVC and FEV 1 respectively, that is, FVC: 81.8%, and FEV 1: 89.15%. The improvement in the self-image item of the patients after surgery on the SRS- 22 questionnaire is very significant. Conclusions The pulmonary function tests show that these scoliotic patients have a significant progressive improvement of FVC and FEV 1 at one and two years postsurgery, compared with the preoperative values.