Anterior thoracoscopic techniques for the correction of adolescent idiopathic scoliosis
- VernacularTitle:胸腔镜下前路矫形治疗青少年特发性胸椎侧凸
- Author:
Cao YANG
;
Askin GEOFFREY
;
Shuhua YANG
- Publication Type:Journal Article
- Keywords:
Thoracoscopy;
Scoliosis;
Internal fixators
- From:
Chinese Journal of Orthopaedics
2000;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of thoracoscopic techniqu es for the anterior correction of adolescent idiopathic scoliosis. Methods Betwe en March 2000 and November 2002, 33 patients with adolescent idiopathic scoliosi s were selected to undergo thoracoscopic instrumentation, correction, and fusion . There were 26 females and 7 males. The average age at surgery was 13.6 years ( range, 10 to 18 years). All patients had idiopathic thoracic curves of typeⅠacc ording to the Lenke classification system, 24 of whom were typeⅠA, and 9 typeⅠ B. The average preoperative Cobb angle of the primary thoracic curve was 57.4?( range, 43? to 68?), and that of the compensatory lumbar curve was 32.0?(range , 20? to 47?). 27 patients were an averaged 6.3? of hypokyphosis (range, 0? to 18?). All 33 patients underwent endoscopic anterior release, instrumentation , correction and intervertebral fusion using the CD Horizon Eclipse system. Para meters including coronal Cobb angle of the primary thoracic curve, the compensat ory lumbar curve and thoracic kyphosis, were measured to assess coronal and sagi ttal correction. Results The instrumented levels were from T4 to T12. The averag e number of levels instrumented for each patient was 7.4 (range, 5 to 9). Operat ive times averaged 3 h and 48 min (range, 2 h 40 min to 5 h 30 min). Blood loss averaged 308 ml (range, 100 to 500 ml). Hospitalization averaged 4.4 days (range , 3 to 9 days). The average follow-up period was 20.6 months (range, 6 to 36 mon ths). The correction for the primary thoracic curve averaged 60.2%, and the comp ensatory lumbar curve averaged 50.3%. Correction with hypokyphosis averaged 20.4 ?. One patient developed pseudoarthrosis and rod fracture. Two patients experie nced transient chest wall numbness. Conclusion Anterior thoracoscopic correction of adolescent idiopathic scoliosis has the advantages of minimal invasion and s horter rehabilitation period. It can also provide the same corrective effect com paring to conventional open thoracotomy.
