Zhang Zhaoquan, Song Zhibo, Yang Xiaochen, Li Tao, Bi Ni, Wang Yingsong
Department of Orthopaedics of Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Clin Spine Surg. 2022 Jun 1;35(5):E483-E489. doi: 10.1097/BSD.0000000000001284. Epub 2021 Dec 15.
A retrospective study.
The aim was to evaluate the relationships of Cobb angle and pulmonary function tests (PFTs) changes in severe spinal deformity and underwent posterior vertebral column resection (PVCR).
No previous study focused on the correlation of deformity correction and PFTs changes in patients with cobb angle >90 degrees.
PFTs values [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and percent-predicted values FVC%, FEV1%] were evaluated preoperative and at 2 years after PVCR. FVC% <80% were defined as restrictive ventilation dysfunction (RVD), the severity of RVD were divided into mild (FEV1% ≥70%), moderate (70% > FEV1% ≥50%) and severe (FEV1% <50%). The relationships among PFTs values improvements and all possible impact factors (mainly correction cobb angle) collected in this study were analyzed. PFTs data were compared among the 3 RVD subgroups (mild vs. moderate vs. severe) and between residual >30 versus <30 degrees.
A total of 53 cases (28 male/25 female, mean ages 18.9 Y) underwent PVCR in one center from 2004 to 2016 were enrolled cobb angle. When 2 years after PVCR, average PFTs values showed significant improvements. PFTs values changes showed no correlation with correction rate and correction angle. The only significant impact factor in this study for FVC, FVC%, FEV1 improvements was preoperative FVC% and the only impact factor for FEV1% improvement was preoperative FEV1%, the relationships were negative. In accordance with the regression analysis, PFTs values improvements among the 3 RVD subgroups from high to low was severe>moderate>mild. However, patients with residual cobb angle <30 degrees had less PFTs values improvements than patients with residual cobb angle >30 degrees.
Two years after PVCR, PFTs values were significantly improved. There is no linear correlation between cobb angle change and PFTs values improvements. Lower preoperative FVC% and FEV1% indicate more PFTs values improvements at 2 years post-PVCR.
Level III.
一项回顾性研究。
旨在评估严重脊柱畸形并接受后路脊柱全椎体切除术（PVCR）患者的Cobb角与肺功能测试（PFTs）变化之间的关系。
此前尚无研究关注Cobb角>90度患者的畸形矫正与PFTs变化之间的相关性。
在PVCR术前及术后2年评估PFTs值[用力肺活量（FVC）、第1秒用力呼气量（FEV1）以及预测值百分比FVC%、FEV1%]。FVC%<80%被定义为限制性通气功能障碍（RVD），RVD的严重程度分为轻度（FEV1%≥70%）、中度（70%>FEV1%≥50%）和重度（FEV1%<50%）。分析本研究中收集的PFTs值改善情况与所有可能的影响因素（主要是矫正Cobb角）之间的关系。在3个RVD亚组（轻度与中度与重度）之间以及残留Cobb角>30度与<30度之间比较PFTs数据。
2004年至2016年在一个中心共有53例（28例男性/25例女性，平均年龄18.9岁）接受PVCR的患者纳入研究Cobb角。PVCR术后2年时，平均PFTs值显示出显著改善。PFTs值变化与矫正率和矫正角度无相关性。本研究中FVC、FVC%、FEV1改善的唯一显著影响因素是术前FVC%，FEV1%改善的唯一影响因素是术前FEV1%，二者呈负相关。根据回归分析，3个RVD亚组中PFTs值改善程度从高到低为重度>中度>轻度。然而，残留Cobb角<30度的患者PFTs值改善程度低于残留Cobb角>30度的患者。
PVCR术后2年，PFTs值显著改善。Cobb角变化与PFTs值改善之间无线性相关性。术前较低的FVC%和FEV1%表明PVCR术后2年PFTs值改善程度更大。
三级。
