Changes in residual volume relative to vital capacity and total lung capacity after arthrodesis of the spine in patients who have adolescent idiopathic scoliosis.

We evaluated pulmonary functions before correction and again after a mean follow-up of three years in thirty-five patients who had adolescent idiopathic scoliosis. The mean age (and standard deviation) at the time of correction was 13.7 +/- 1.8 years, and at the time of follow-up it was 17.1 +/- 2.5 years. The findings in the patients were compared with those in matched normal control subjects. With the exception of forced vital capacity, all of the determinations of absolute pulmonary volume increased postoperatively, but the increases were not all proportional. When the preoperative and follow-up determinations were expressed as percentages of the predicted pulmonary volumes (on the basis of age) to eliminate any effects of the difference in age, there was no change in total lung capacity, but vital capacity and forced vital capacity were significantly reduced. In addition, there was a significant increase in residual volume. Of the mean increase in total lung capacity after correction of the scoliosis, 82 per cent was due to an increase in residual volume and 18 per cent, to an increase in vital capacity. However, in control subjects age-matched at the time of follow-up, the increase in vital capacity contributed 69 per cent of the mean increase in total lung capacity, a very marked difference from the findings in the patients who had scoliosis. In addition, two pulmonary-volume ratios--residual volume to vital capacity and residual volume to total lung capacity--increased in a highly significant fashion (Mann-Whitney test, p < 0.001) after arthrodesis of the spine.(ABSTRACT TRUNCATED AT 250 WORDS)