Short term effect and effect on rate of lung function decline after surgery for neuromuscular or syndromic scoliosis

Esther S Veldhoen, Anneloes de Vries, Tom P C Schlosser, Moyo C Kruyt, Ruben P A van Eijk, Joyce M Tersmette, Erik H Hulzebos, Ludo W van der Pol, Roelie M Wösten-van Asperen, Cornelis K van der Ent

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Abstract

Introduction: Understanding the impact of scoliosis surgery on lung function is important for counseling patients about risks and benefits of surgery. We prospectively compared the trends in lung function test (LFT) results before and after scoliosis surgery in children with neuromuscular diseases or dysmorphic syndromes. We hypothesized a stabilization. Methods: We prospectively included children with neuromuscular or syndromic scoliosis able to perform LFTs. We studied (forced) vital capacity ([F]VC), ratio of forced expiratory volume in 1 s (FEV1) and FVC, and peak expiratory flow (PEF). Preoperative LFT results were compared with results 3–4 months after surgery. The mean monthly change in LFT results up to 2 years after surgery was compared with the preoperative natural history using linear mixed-effects models. Results: We included 43 patients. No significant change was observed in absolute values of (F)VC, FEV1/FVC, and PEF before and after surgery. In 23 neuromuscular patients median standardized VC, FVC, and PEF decreased significantly after surgery from 43% to 33%, 42% to 31%, and 51% to 40%, respectively. In 20 syndromic patients, median FVC decreased from 68% to 65%. The monthly rate of change in FVC did not change significantly in both groups with a mean difference of 0.18% (95% CI: −0.27, −0.61) and −0.44% (95% CI: −1.05, 0.16). Conclusion: No stabilization of lung function 3–4 months after scoliosis surgery was observed in children with neuromuscular and syndromic scoliosis with restrictive lung function disease. The effect on the rate of lung function decline remains inconclusive.

Original languageEnglish
Pages (from-to)1303-1309
Number of pages7
JournalPediatric Pulmonology
Volume57
Issue number5
Early online date17 Feb 2022
DOIs
Publication statusPublished - May 2022

Keywords

  • lung function
  • neuromuscular disease
  • scoliosis

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