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Thoracic volume changes in scoliosis surgery
K B Wood1, M J Schendel, M B Dekutoski
1Twin Cities Scoliosis-Spine Center, University of Minnesota, Minneapolis, USA.
Spine
|March 15, 1996
Summary
ISOLA instrumentation with sublaminar wiring significantly increased chest volume in adolescent idiopathic scoliosis patients compared to Cotrel-Dubousset. This suggests a potential benefit for pulmonary function, though clinical significance requires further study.
Area of Science:
- Orthopedic surgery
- Spinal deformities
- Thoracic biomechanics
Background:
- Previous studies on Harrington instrumentation showed variable pulmonary function improvements in adolescent idiopathic scoliosis.
- The impact of modern spinal instrumentation techniques on chest volume remains largely undetermined.
Purpose of the Study:
- To compare the immediate changes in thoracic cage volume between ISOLA and Cotrel-Dubousset instrumentation.
- To evaluate the effectiveness of the ISOLA sublaminar wire translational technique versus the Cotrel-Dubousset derotation method.
Main Methods:
- Computed tomography scans were used to analyze chest volume in 18 patients treated with ISOLA and 13 with Cotrel-Dubousset.
- Cross-sectional areas and thoracic cage volumes were calculated from T3 to T10 vertebral levels.
Main Results:
- ISOLA instrumentation, particularly for single thoracic curves (King-Moe Type III), demonstrated a statistically significant increase in chest volume.
- 17 of 18 ISOLA patients experienced chest volume increase, while half of Cotrel-Dubousset patients showed a decrease.
Conclusions:
- ISOLA instrumentation utilizing sublaminar wiring appears to enhance chest volume in adolescent idiopathic scoliosis.
- Further research is necessary to ascertain the clinical implications of these volume changes.