Learning Curve for the Thoracoscopic Correction of Spinal Deformities.
10.4184/jkss.2003.10.3.261
- Author:
Hak Sun KIM
1
;
Yun Rak CHOI
;
Hwan Mo LEE
;
Sung Hwan MOON
;
Kyung Hee KIM
;
Jin Oh PARK
;
Jung Won HA
;
Dong Eun SHIN
Author Information
1. Department of Orthopaedic Surgery, Yonsei University, Seoul, Korea. haksunkim@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Scoliosis;
Thoracoscopy;
Learning curve
- MeSH:
Bone Transplantation;
Congenital Abnormalities*;
Humans;
Intercostal Nerves;
Korea;
Learning Curve*;
Learning*;
Prospective Studies;
Pulmonary Atelectasis;
Radiography;
Scoliosis;
Thoracic Surgery, Video-Assisted;
Thoracoscopy;
Thoracotomy;
Transplants
- From:Journal of Korean Society of Spine Surgery
2003;10(3):261-268
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: Twenty-six consecutive cases were prospectively studied by chart review and radiography. OBJECTIVES: The aim of this study was to find the learning curve of spinal thoracoscopy in spinal deformity surgery. SUMMARY OF LITERATURE REVIEW : Although the efficacy and learning curve of thoracoscopic deformity spinal surgery are well documented in many countries, there is no report in Korea. METHODS: Twenty-six consecutive patients who were underwent VATS were studied. Idiopathic scoliosis was diagnosed in 23 patients (King type II in 15, type III in 5, type IV in 3), neuromuscular scoliosis in 2 and kyphotic deformity in one. In 14 cases of idiopathic scoliosis VATS for anterior release, bonegraft and instrumentation were performed. In the remaining 12 cases of anterior release, bone graft by VATS was done without instrumentation. RESULTS: The average number of discs excised was 5.2+/-0.97. The average time of surgery for the 14 cases was 7.3+/-1.3 hours, which represented 1.37+/-0.25 hours per disc. Excluding the time of instrumentation in the 26 cases, the average time for anterior release and bone grafting was 3.87+/-0.87 hours, which represented 0.76+/-0.18 hours per disc. The average operation time diminished as the series continued. Average blood loss was 748.9+/-254 mL, which represented 152.6+/-65.6 mL per disc. The Cobb's angle was corrected by 62% on average. Complications were found in 11 cases: screw cap breakage in 3, atelectasis in 4, and intercostal nerve injury in 4. There was no serious complication. CONCLUSIONS: VAST for spinal deformity is a safe and effective alternative to thoracotomy, however, the learning curve for this procedure is quite difficult.
