Preoperative predictors of postoperative pulmonary complications in neuromuscular scoliosis

Gi Run Kang, Seung-Woo Suh, Il Ok Lee

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Abstract

Background Neuromuscular scoliosis (NMS) is associated with progressive restrictive lung disease and an increased risk of prolonged ventilation following surgery. This study reports the experiences of a single institution and evaluates whether preoperative pulmonary function tests (PFT) can predict the development of postoperative pulmonary complications. Methods Correlations between preoperative PFT (forced expired volume in 1 s, FEV1; forced vital capacity, FVC) findings and postoperative pulmonary complications were searched for among 74 NMS patients who underwent surgical correction at our medical center from 2002 to 2008. Results Thirty-seven patients (50%) developed a pulmonary complication. The independent factors found to contribute to the development of a pulmonary complication were: FEV 1 <40% of the predicted value (P = 0.007), FVC <39.5% of the predicted value (P = 0.005), a larger Cobb angle (>69°) (P = 0.002), and older age (>16.5 years) (P = 0.027). Of these 37 patients, 6 needed postoperative ventilation. PFT findings found to be independently associated with the need for postoperative ventilation were: FEV 1 <40% of the predicted value (P = 0.017) and FVC \39.5% of the predicted value (P = 0.015). Conclusions NMS patients with a preoperative FVC of <39.5% of the predicted value, an FEV 1 <40% of the predicted value, a Cobb angle of>69°, or age >16.5 years were found to be more likely to develop a postoperative pulmonary complication.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalJournal of Orthopaedic Science
Volume16
Issue number2
DOIs
Publication statusPublished - 2011 Feb 11

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ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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