Abstract
Aim: To examine the effect of the anterior and posterior approaches for the surgical correction of scoliosis on pulmonary function, curve correction and patient satisfaction.
Methods: Thirty-five patients with adolescent idiopathic scoliosis undergoing surgical treatment were evaluated with spirometry, assessing volume (FVC) and flow (FEV1) pre and post-operatively . They were followed for a minimum of two years and their results were compared with the normalised data for their age group. The patients were divided into three groups based on the surgical approach and the amount of correction. The patients in group one underwent posterior spinal fusions and had greater than 60% correction of pre-operative Cobb angles. Those in group two underwent posterior spinal fusions and had less than 60% correction of their pre-operative Cobb angles. A combined anterior and posterior spinal fusion was used for the patients in group three with greater than 60% correction in their pre-operative Cobb angles.
Results: The patients in group one had significantly improved pulmonary function values at follow-up. The patients in group two all returned to pre-operative pulmonary function values and the patients in group three had improved pulmonary function values but this was not significant.
Conclusions: Patients with purely posterior surgery and large Cobb angle corrections demonstrated a statistically significant increase in lung function values. Large corrections greater than 60 degrees in combined anterior/posterior procedures increased lung function values but not significantly. We suggest that large corrections can be achieved with posterior surgery alone using pedicle screws for caudal fixation and question the need for a thoracotomy.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
