title: Six-year follow-up study on the effect of combined anterior and posterior spinal fusion on lung function and quality of life in young people with adolescent idiopathic scoliosis.
abstract: OBJECTIVE
  The effects of spinal surgery on lung function and quality of life (QoL) are important patient outcomes. Long-term follow-up of lung function and QoL in those undergoing combined anterior and posterior spinal fusion (A/PSF) for adolescent idiopathic scoliosis (AIS) is poorly documented with only one study extending beyond 2 years, though available evidence points to a decrement in lung function. Our study evaluated long-term change in lung function and QoL following A/PSF for AIS.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Patients with AIS.
  
  
  METHODS
  Tertiary paediatric respiratory centre and national spinal service.
  
  
  METHODS
  Spirometry was performed along with QoL (Scoliosis Research Society-22 (SRS-22) questionnaire). Paired t test and one-way analysis of variance were used to compare pre-A/PSF and post-A/PSF data.
  
  
  RESULTS
  Data were available for 12 patients (9 female) who underwent A/PSF at mean 13.8 (range 11.8-15) years. Mean follow-up was undertaken 5.8 (range 4.1-6.8) years postoperatively. Height increased from mean (SD) 169 (9) cm preoperatively to 175 (5) cm at follow-up (p<0.01). Scoliosis corrected from 100 (15)° to 29 (11)° (p<0.001). Mean (SD) forced expiratory volume in 1 s was -3.4 (1.4) z scores preoperatively versus -3.3 (1) z scores postoperatively (p=0.85); and forced vital capacity was -3.4 (1.7) ) z scores pre-A/PSF and -3.4 (1.1) z scores post-A/PSF (p=0.83). SRS-22 scores improved mean (SD) of 3.6 (0.3) preoperatively to 4.2 (0.3) at 2 years postoperatively, and 4.4 (0.4) at 6 year follow-up (p<0.001, analysis of variance). High patient satisfaction rates (4.8 (0.3)) were recorded. No correlation was noted between changes in forced expiratory volume in 1 s (r=-0.15, p=0.63) or forced vital capacity (r=-0.12, p=0.71) and change in long-term SRS-22 score.
  
  
  CONCLUSIONS
  Long-term follow-up of patients with AIS suggests no deficit in pulmonary function, while QoL shows incremental improvement and patient satisfaction is high over 6 years after A/PSF.
authors.affiliation: Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Urquhart
authors.affiliation: Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: S
authors.initials: S
authors.lastname: Gallella
authors.affiliation: Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: D
authors.initials: D
authors.lastname: Gidaris
authors.affiliation: Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: E
authors.initials: E
authors.lastname: Brady
authors.affiliation: Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: S
authors.initials: S
authors.lastname: Blacklock
authors.affiliation: Scottish National Spine Deformity Centre, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: A I
authors.initials: AI
authors.lastname: Tsirikos
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D012600:Scoliosis / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome
keywords: Adolescent Health; Qualitative Research; Respiratory; Scoliosis; Spinal Surgery