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

Esther S Veldhoen1, Anneloes de Vries1, Tom P C Schlosser2

  • 1Pediatric Intensive Care Unit, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.

Pediatric Pulmonology
|February 17, 2022
PubMed

Insights

Scoliosis surgery did not stabilize lung function in children with neuromuscular or syndromic conditions. Lung function tests showed a decline in neuromuscular patients post-surgery, with inconclusive effects on the rate of decline.

Area of Science:

  • Pediatric Orthopedics
  • Pulmonology
  • Medical Engineering

Background:

  • Scoliosis surgery in children with neuromuscular diseases or dysmorphic syndromes requires careful patient counseling regarding potential impacts on lung function.
  • Understanding the postoperative trajectory of lung function is crucial for managing expectations and optimizing patient outcomes.

Purpose of the Study:

  • To prospectively compare lung function test (LFT) results before and after scoliosis surgery in pediatric patients with neuromuscular diseases or dysmorphic syndromes.
  • To evaluate whether scoliosis surgery leads to stabilization or alters the rate of lung function decline in these patient populations.

Main Methods:

  • Prospective study including 43 children with neuromuscular or syndromic scoliosis capable of performing LFTs.
  • Analysis of forced vital capacity ([F]VC), FEV1/FVC ratio, and peak expiratory flow (PEF) preoperatively and 3-4 months postoperatively.
  • Comparison of the mean monthly change in LFTs up to 2 years post-surgery with preoperative trends using linear mixed-effects models.

Main Results:

  • No significant change in absolute LFT values ( [F]VC, FEV1/FVC, PEF) was observed immediately after surgery.
  • A significant decrease in median standardized lung function was noted in neuromuscular patients post-surgery (VC: 43% to 33%, FVC: 42% to 31%, PEF: 51% to 40%).
  • Syndromic patients showed a smaller decrease in median FVC (68% to 65%), and the rate of FVC change remained non-significantly altered in both groups.

Conclusions:

  • Scoliosis surgery does not appear to stabilize lung function in children with neuromuscular or syndromic scoliosis and restrictive lung disease.
  • The long-term effect of scoliosis surgery on the rate of lung function decline in these pediatric populations remains inconclusive based on this study.
Abstract

Keywords:
lung functionneuromuscular diseasescoliosis

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