Cardiorespiratory Function Does Not Improve 2 Years After Posterior Surgical Correction of Adolescent Idiopathic Scoliosis.
METHODS
A prospective evaluation of cardiorespiratory function following spinal fusion in adolescent idiopathic scoliosis (AIS).


OBJECTIVE
To evaluate the cardiopulmonary function during exercise in patients with severe AIS, before and 2 years after undergoing a posterior spinal fusion.


BACKGROUND
After surgical correction of scoliosis, a greater cardiorespiratory adaptation to exercise would be expected from correction of the rib cage associated with the spine deformity. However, there is no clear evidence regarding whether tolerance to maximum exercise improves in the medium term after surgery in patients with severe curves.


METHODS
We include patients with AIS proposed for posterior surgical correction aging between 12 and 17 years. Every patient had a Cobb angle >45° and a Lenke type 1A scoliosis. Cardiac and respiratory functional measures, such as heart rate and blood pressure, maximum oxygen consumption (VO2max), eliminated volume of carbon dioxide (VCO2), quotient between ventilation and volume of exhaled carbon dioxide (VE/CO2), respiratory exchange rate, ventilatory capacity at maximal exercise (VEmax), were recorded before and 2 years after surgery.


RESULTS
Twenty patients were included in our study, 15 girls and 5 boys, with an average age of 13 years. The main scoliotic curve was corrected in the coronal plane in an average of 71.9%. The maximal aerobic power expressed by body weight normalized VO2max was found preoperatively to have an average of 30.9 ± 6.2 mL/kg/minute, indicating a poor aerobic capacity, which did not improve at final follow-up, decreasing to a mean value of 29.3 ± 5.7 but without statistical significance. However, the percentages of curve correction showed a statistically significant correlation with VO2max (r = 0.534; P < 0.05).


CONCLUSIONS
Patients with severe adolescent idiopathic scoliosis Lenke type 1A showed limited cardiorespiratory tolerance to maximum exercise that did not improve 2 years after surgery.


METHODS
3.
Department of Orthopedic Surgery, Hospital Ramón y Cajal, Madrid, Spain.
Alejandro
A
Lorente
Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.
Carlos
C
Barrios
Department of Orthopedic Surgery, Hospital Ramón y Cajal, Madrid, Spain.
Jesús
J
Burgos
Spine Unit, La Fraternidad-Muprespa Hospital, Madrid, Spain.
Eduardo
E
Hevia
Department of Pediatric Cardiology, Hospital Ramón y Cajal, Madrid, Spain.
Luis
L
Fernández-Pineda
Department of Orthopedic Surgery and Traumatology, Hospital Infanta Cristina, Badajoz, Spain.
Rafael
R
Lorente
Department of Orthopedic Surgery and Traumatology, Hospital de Vila Franca de Xira, Povos, Vila Franca de Xira, Portugal.
Bárbara
B
Rosa
Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.
Cristina
C
Pérez-Encinas
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D010101:Oxygen Consumption / Q000502:physiology*; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D012600:Scoliosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery