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Help with my friend's paper?
well a friend of mine studies orthopedics and he seeks for native speakers to correct his paper which he wants to submit to English magazines…Dunno if Fluther is the right place to do so…but…Any comments or corrections are welcomed!!and feel free to ignore this essay..
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In this study, we found that postoperative lung height in AIS patients was statistically increased compared with preoperative values. However, convex to concave lung volume ratio and lung volume including left, right and total lung volume had no statistically significant difference a week after correction surgery.
Clayton J. Adam et al reviewed 28 idiopathic scoliosis patients using 3D-CT volumetric reconstruction. They found there were statistical differences in both lung volumes and lung volume ratios compared with normal controls. Eun Mi Chun et al studied 99 cases (77 asymptomatic AIS patients and 22 normal controls) and indicated concave side lung volume was comparatively more decreased than convex side lung volume. The value of ratio in our study was 1.181±0.193, which has no statistical difference with the value (1.1823±0.1158) in Eun Mi Chun’s research (P>0.05).
Several studies have reported the changes in pulmonary function after posterior segmental spinal instrumentation and fusion surgery . Vedantam et al reported 47 cases following PSF without thoracoplasty and showed that the value of absolute FVC and FEV1 improved significantly at final follow-up. However, the percent predicted values did not show significant differences between preoperative and final follow-up. Recently, Kim et al researched 139 AIS patients following posterior segmental spinal fusion (PSSF) and instrumentation with iliac crest bone graft (ICBG) and demonstrated statistically significant improvement of absolute and percent predicted PFTs at 2 years postoperative. Satoru Demura et al examined 154 cases following PSF without thoracoplasty and showed significant increase in all absolute values in FVC, FEV1, and TLC. But change in percent predicted values were not statistically significant, which was in contrast to the report of Kim et al13.
In our current study, 3D-CT imaging and lung volume and height measurement were used to evaluate the changes in pre- and postoperative lung morphology in AIS patients after posterior segmental spinal instrumentation and fusion surgery. We found that the correction operation only corrected spinal deformity and increased lung height (P<0.05), while lung volume and convex to concave lung volume ratio were not affected (P>0.05). And that, our study showed that the change in postoperative lung morphology had positive correlation with the correction of the main thoracic Cobb angle (P<0.05). On the other hand, Winnie CW Chu et al6 used dynamic MR studied the lung volume, chest wall and diaphragmatic motion between inspiration and expiration in AIS patients and found that lateral chest wall and diaphragmatic motions were improved six months after posterior spinal fusion.
From the above, we can predict the process of change in postoperative lung morphology in AIS patients. Postoperatively, from a week to six months lung was not adapted to the corrective thorax. Because the number and volume of pulmonary alveolar didn’t increase significantly in such a short time, therefore the lung height increased while the change in total lung volume change wasn’t obvious. Only showed an increase lateral chest wall and diaphragmatic motions. Previous research had showed rapid growth of pulmonary alveoli peaks near 2 years of age, it continues until age 16 years in girls and 18 years in boys . Six months to 2 years postoperative or further, lung has adapted to the corrective thoracic. What’s more, with the growth of AIS patient, the number and volume of pulmonary alveolar increased, showing improvement in pulmonary function as well as an increase in lung volume.
There were three limitations in this retrospective study. The first was the radiation damage to AIS patients. However, the 3D-CT scans performed for AIS patients pre- and postoperatively were rather to observe the vertebral structure and ensure the accuracy of pedicle screws placement than to research alone. The second limitation was that sample size of our study was small. Another weakness of this study was the lack of long-term follow-up for postoperative AIS patients. Therefore, it required larger samples and longer-term follow-up study in the future.
As we all know, immediately postoperative pulmonary function in AIS patients had no clinical significance, but immediately postoperative CT scans could relatively illustrate the change in lung morphology. In conclusion, our current study demonstrated the change in lung morphology in AIS patients a week after posterior segmental spinal instrumentation and fusion surgery and filled the vacancy about related information. It showed lung height in AIS patients was statistically increased immediately postoperatively while convex to concave lung volume ratio and lung volume including left, right and total lung volume showed no statistical difference compared to the preoperative values. What’s more, the change in left lung volume and total lung height showed positive correlation with the correction of the main thoracic Cobb angle. While the other changes showed no significant correlation with the patients’ general data.