title: The influence of kyphosis correction surgery on pulmonary function and thoracic volume.
abstract: METHODS
  A clinical study.
  
  
  OBJECTIVE
  To measure the changes in pulmonary function and thoracic volume associated with surgical correction of kyphotic deformities.
  
  
  BACKGROUND
  No prior study has focused on the pulmonary function and thoracic cavity volume before and after corrective surgery for kyphosis.
  
  
  METHODS
  Thirty-four patients with kyphosis underwent posterior deformity correction with instrumented fusion. Preoperative and postoperative pulmonary function was measured, and pulmonary function grade was evaluated as mild, significant, or severe. The change in preoperative to postoperative pulmonary function was analyzed, using 6 comparative subgroupings of patients on the basis of age, severity of kyphosis, location of kyphosis apex, length of follow-up time after surgery, degree of kyphosis correction, and number of segments fused. A second group of 19 patients also underwent posterior surgical correction of kyphosis, which had thoracic volume measured preoperatively and postoperatively with computed tomographic scanning.
  
  
  RESULTS
  All of the pulmonary impairments were found to be restrictive. After surgery, most of the patients had improvement of the pulmonary function. Before surgery, the pulmonary function differences were found to be significant based on both severity of preoperative kyphosis (<60° vs. >60°) and location of the kyphosis apex (above T10 vs. below T10). Younger patients (younger than 35 yr) were more likely to exhibit statistically significant improvements in pulmonary function after surgery. However, thoracic volume was not significantly related to pulmonary function parameters. After surgery, average thoracic volume had no significant change.
  
  
  CONCLUSIONS
  The major pulmonary impairment caused by kyphosis was found to be restrictive. Patients with kyphosis angle of 60° or greater or with kyphosis apex above T10 had more severe pulmonary dysfunction. Patients' age was significantly related to change in pulmonary function after surgery. However, the average thoracic volume had no significant change after surgery.
  
  
  METHODS
  3.
authors: *Orthopedic Department, Peking University Third Hospital, Beijing, China; and †Harvard Medical School, Boston, MA; and Carl J Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors: Yan
authors: Y
authors: Zeng
authors: Zhongqiang
authors: Z
authors: Chen
authors: Desi
authors: D
authors: Ma
authors: Zhaoqing
authors: Z
authors: Guo
authors: Qiang
authors: Q
authors: Qi
authors: Weishi
authors: W
authors: Li
authors: Chuiguo
authors: C
authors: Sun
authors: Ning
authors: N
authors: Liu
authors: Andrew P
authors: AP
authors: White
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013902:Radiography, Thoracic / Q000379:methods; D020127:Recovery of Function; D012129:Respiratory Function Tests; D013123:Spinal Fusion / Q000295:instrumentation; D035423:Thoracic Cavity; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult