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How Is Pulmonary Function and Exercise Tolerance Affected in Patients With AIS Who Have Undergone Spinal Fusion?

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Abstract

Study Design

Prospectively enrolled AIS patients who underwent spinal fusion, with 2 year follow-up.

Objectives

To evaluate the cardiovascular fitness and activity level in patients with AIS pre— and post–spinal fusion and to determine if initial curve magnitude or pulmonary function is predictive of exercise capacity.

Summary of Background Data

Researchers have tried to link pulmonary function testing (PFT) to exercise capacity; the results are mixed. Some report no improvement in PFTs or aerobic activity after surgical correction, and PFT measures were not predictive of exercise capacity. Conflicting results have shown Vo 2max results to fall within normal range in AIS patients while PFTs show minimal impairment.

Methods

AIS patients underwent PFT and oxygen consumption (VO 2) testing during a submaximal graded exercise test (GXT) pre— and post–spinal fusion. Vo 2max was predicted in those patients who completed the test to 85% of maximal heart rate. Pre- to postoperative changes were assessed and then compared to age-matched control subjects. Correlations between Vo 2max and curve severity, pulmonary function, and activity level were assessed.

Results

Thirty-seven patients participated. Vo 2max was predicted in 23 patients pre- and postoperation. There was a significant reduction in Vo 2max postfusion (39.5 ± 6.5 mL/kg/min vs 42.1 ± 8.1 mL/kg/min, p =.033); however, compared with controls (40.5 ± 6.5 mL/kg/min), all data were within the normal range (p >.05). AIS patients reporting high activity had significantly greater Vo 2max than those reporting low activity both pre and postoperatively, but this difference only met statistical significance preop (p <.05). Curve magnitude and PFT measures were not found to correlate with Vo 2max (p >.05).

Conclusions

Vo 2max in patients with AIS is within normal range both pre- and postfusion. Pulmonary limitations are accommodated for with a slightly increased breathing rate and a slightly reduced overall workload. Activity level rather than curve severity affects Vo 2max outcomes following fusion in AIS.

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Authors and Affiliations

  1. Texas Scottish Rite Hospital for Children, 2222 Welborn St, Dallas, TX, 75219, USA

    Kelly A. Jeans MS, Lori A. Karol MD & Anna M. McClung RN

  2. Nemours Children’s Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA

    John F. Lovejoy MD

Authors
  1. Kelly A. Jeans MS
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  2. John F. Lovejoy MD
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  3. Lori A. Karol MD
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  4. Anna M. McClung RN
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Correspondence to Kelly A. Jeans MS.

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Jeans, K.A., Lovejoy, J.F., Karol, L.A. et al. How Is Pulmonary Function and Exercise Tolerance Affected in Patients With AIS Who Have Undergone Spinal Fusion?. Spine Deform 5, 416–423 (2017). https://doi.org/10.1016/j.jspd.2017.04.001

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