Endoscopic instrumentation, correction, and fusion of idiopathic scoliosis

• Published in: The spine journal 2001, Vol.1 (3), p.190-197
• Main Authors: Picetti, George D, Ertl, Janos P, Bueff, H.Ulrich
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anterior instrumentation; Autogenous bone graft; Bone Transplantation - methods; Child; Combined Modality Therapy; Diskectomy; Diskectomy - methods; Endoscopic surgery; Endoscopy - methods; Female; Humans; Internal Fixators; Male; Minimally Invasive Surgical Procedures - methods; Prognosis; Radiography; Range of Motion, Articular - physiology; Recovery of Function; Retrospective Studies; Risk Assessment; Sampling Studies; Scoliosis; Scoliosis - diagnostic imaging; Scoliosis - surgery; Severity of Illness Index; Spinal Fusion - methods; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - surgery; Thorascopic surgery; Treatment Outcome
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/S1529-9430(01)00030-4

Background context: Endoscopic techniques have been used since 1993 to treat thoracic disk disease. Thorascopic techniques evolved into means of treating not only disk disease but also correcting thoracic spinal deformity with instrumentation and fusion. Purpose: To evaluate the efficacy of endoscopic instrumentation, correction, and fusion of thoracic idiopathic scoliosis. Study design: A retrospective review of 50 patients who have undergone endoscopic instrumentation, correction, and fusion for scoliosis. Patient sample: Fifty consecutive patients undergoing treatment for primary thoracic idiopathic scoliosis. Outcome measures: Evaluation of operative time, curve correction, and fusion rates were evaluated. Methods: Fifty patients with the diagnosis of primary thoracic scoliosis underwent thoracoscopic techniques of instrumentation, correction, and fusion. On follow-up, the patients were evaluated for spinal alignment restoration, axial derotation, postoperative pain, rehabilitative time, and complications. Results: The initial curve correction averaged 50%, improving to over 68% in the last 10 cases. Hypokyphosis correction averaged 21 degrees. Additionally, there has been a decrease in rehabilitation time, less time off work or school, and decreased blood loss and postoperative pain. There were 14 complications and no deaths recorded. The factors involved in a successful fusion include total diskectomy, complete cartilaginous end plate removal, and autogenous bone graft. Conclusions: The initial results of the thoracoscopic-assisted techniques for primary thoracic scoliosis are promising. As with most evolving techniques, surgical times are decreasing and rates of correction are improving.