Pulmonary function in long-term survivors of thoracoplasty

Pulmonary function was assessed in 15 patients who had undergone thoracoplasty (TPL) approximately 30 years previously. Relation was noted to extent of TPL performed, side of TPL, age at TPL, and degree of secondary scoliosis. Test results showed mixed restrictive and obstructive defects. Although extent of TPL did not correlate with current lung function values, the restrictive defect was probably caused by a mixture of (a) compression of lung by TPL and (b) fibrosis from old pulmonary tuberculosis. The obstructive defect might have been due to the TPL procedure itself or to chronic bronchitis related to (a) previous pulmonary TB or (b) cigarette smoking, since 14 subjects were former or current smokers. That Dsb was relatively preserved suggests that pulmonary hypertension as a late sequela of TPL may be reactive (secondary to hypoxemia and respiratory acidemia) rather than obliterative.