Improvement in pulmonary function in patients having combined anterior and posterior spine fusion for myelomeningocele scoliosis.

Thirteen patients with myelomeningocele scoliosis whose surgery necessitated anterior exposure of the thoracic spine were tested for changes in pulmonary function following spinal stabilization. The majority of patients exhibited a T12 level paralysis and a mean scoliosis of 72 degrees. Average correction of scoliosis for the series was 63%, and two cases with one level pseudarthrosis had no loss of correction. Ten of 13 patients were tested for pulmonary function one month prior to surgery and an average of ten months postoperatively. Eight of the ten patients demonstrated increase in peak flow postoperatively. Five demonstrated increase in maximum voluntary ventilation, and six cases showed increased functional residual capacity. Forced vital capacity increased in two, decreased in five, and showed no change in three patients. Improvement in peak flow, maximum voluntary ventilation, and functional residual capacity was noted in all five cases with scoliotic deformity in excess of 60 degrees (mean 93 degrees). It is postulated that, following spinal stabilization, these patients are able to improve their thoracic mechanics, enhancing greater expiratory flow with greater endurance.