Postoperative pulmonary complications in children with neuromuscular scoliosis who underwent posterior spinal fusion

Children with neuromuscular scoliosis may develop restrictive pulmonary disease, with substantially lower than normal predicted lung function. Posterior spinal fusion (PSF) is often used to slow down this rapid deterioration of pulmonary function. Postoperatively, these patients frequently develop pulmonary complications. In this retrospective study of 38 patients with neuromuscular scoliosis who underwent PSF, the preoperative vital capacity was related to postoperative pulmonary complications and need for postoperative ventilatory assistance. In two patients who developed postoperative atelectasis and pulmonary edema, the preoperative vital capacity was 44% of that predicted. In six patients who developed atelectasis only, it was 49.2%. In the remaining 30 patients who developed no postoperative pulmonary complications, the average was 64.6%. Low preoperative vital capacity was also shown to correlate with the need for longer postoperative ventilatory assistance. The preoperative vital capacity is an important prognostic parameter in evaluating postoperative pulmonary recovery.