The effect of scoliosis surgery on pulmonary function in spinal muscular atrophy type II patients.
Various results of the previous literature related to surgical effect on pulmonary function of spinal muscular atrophy (SMA) patients might be due to different SMA type, different fusion level and technique. The aim of this study was to determine the value of scoliosis surgery for SMA type II patients with regard to pulmonary function, under the same fusion level, fusion technique and average long-term follow-up.



Ten SMA II patients who underwent spinal correction procedures from 1993 to 2010 were identified. Data on clinical features and pulmonary function, including forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV1), were collected. The data on pulmonary function were divided into preoperative, postoperative short-term (0-5 years), mid-term (5-10 years), and long-term (>10 years). Statistical comparisons were made using the Wilcoxon test for pulmonary function and body weight analysis. Questions were answered by parents on how surgery influenced the frequency of respiratory infection and the ability to sit at school.



The average length of postoperative pulmonary function follow-up was 12.3 years (range 4.9-15.9 years). There was no significant difference in FVC or FEV1between preoperative and each postoperative period. However, a significant decline from mid-term to long-term was observed (p = 0.028). Body weight increased significantly in all postoperative periods and was moderately correlated to pulmonary function (r = 0.526 for FVC). The answers to the questionnaire revealed that 80% of the patients had obvious improvement in the frequency of respiratory infection and 100% were tolerable sitting at school.



Surgical correction for scoliosis in SMA II patients results in pulmonary function being maintained during long-term follow-up. In addition, the advantages of surgery also include body weight gain, better sitting tolerance, and reduced frequency of respiratory infection.
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Shih-Hsiang
SH
Chou
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopaedics, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.
Gau-Tyan
GT
Lin
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Po-Chih
PC
Shen
Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Physical Therapy, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yi-Jing
YJ
Lue
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Cheng-Chang
CC
Lu
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.|Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yin-Chun
YC
Tien
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. enmol@msn.com.|Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. enmol@msn.com.
Yen-Mou
YM
Lu
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012600:Scoliosis / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion; D014897:Spinal Muscular Atrophies of Childhood / Q000503:physiopathology*; D014797:Vital Capacity / Q000502:physiology*; D055815:Young Adult
Body weight; Pulmonary function; Respiratory infection; Scoliosis; Spinal muscular atrophy type II