Yonsei Med J.  2011 Jan;52(1):130-136. 10.3349/ymj.2011.52.1.130.

Video-Assisted Thoracoscopic Surgery Plus Lumbar Mini-Open Surgery for Adolescent Idiopathic Scoliosis

• Chong HS
• Kim HS
• Ankur N
• Kho PA
• Kim SJ
• Kim DY
• Park JO
• Moon SH
• Lee HM
• Moon ES

• KMID: 1106447
• DOI: http://doi.org/10.3349/ymj.2011.52.1.130

Abstract

PURPOSE
The objectives of this study are to describe the outcome of adolescent idiopathic scoliosis (AIS) patients treated with Video Assisted Thoracoscopic Surgery (VATS) plus supplementary minimal incision in the lumbar region for thoracic and lumbar deformity correction and fusion.
MATERIALS AND METHODS
This is a case series of 13 patients treated with VATS plus lumbar mini-open surgery for AIS. A total of 13 patients requiring fusions of both the thoracic and lumbar regions were included in this study: 5 of these patients were classified as Lenke type 1A and 8 as Lenke type 5C. Fusion was performed using VATS up to T12 or L1 vertebral level. Lower levels were accessed via a small mini-incision in the lumbar area to gain access to the lumbar spine via the retroperitoneal space. All patients had a minimum follow-up of 1 year.
RESULTS
The average number of fused vertebrae was 7.1 levels. A significant correction in the Cobb angle was obtained at the final follow-up (p = 0.001). The instrumented segmental angle in the sagittal plane was relatively well-maintained following surgery, albeit with a slight increase. Scoliosis Research Society-22 (SRS-22) scores were noted have significantly improved at the final follow-up (p < 0.05).
CONCLUSION
Indications for the use of VATS may be extended from patients with localized thoracic scoliosis to those with thoracolumbar scoliosis. By utilizing a supplementary minimal incision in the lumbar region, a satisfactory deformity correction may be accomplished with minimal post-operative scarring.

Keyword

Scoliosis; VATS; mini-open retroperitoneal approach

MeSH Terms

Adolescent
Child
Female
Humans
Male
Scoliosis/*surgery
Thoracic Surgery, Video-Assisted/*methods
Treatment Outcome

Figure

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  Fig. 1 Preoperative posteroanterior (A) and lateral (B) radiograph of 12 year-old girl with 40O T6-L2 Lenke type 1A curve. The post-operative 2 year follow-up posteroanterior (C) and lateral (D) radiograph of same patient after VATS and lumbar mini-open surgery and fusion. VATS, Video Assisted Thoracoscopic Surgery.

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  Fig. 2 Preoperative posteroanterior (A) and lateral (B) radiograph of 14 year-old girl with 44O T10-L3 Lenke type 5C curve. The post-operative 3 year follow-up posteroanterior (C) and lateral (D) radiograph of same patient after VATS and lumbar mini-open surgery and fusion. VATS, Video Assisted Thoracoscopic Surgery.

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