Thoracoscopic Anterior Instrumentation and Fusion as a Treatment for Adolescent Idiopathic Scoliosis: A Systematic Review of the Literature

被引：0

作者：

Padhye K. ^{[1
]}

Soroceanu A. ^{[2
]}

Russell D. ^{[3
]}

El-Hawary R. ^{[1
]}

机构：

[1] Division of Orthopaedic Surgery, IWK Health Centre, 5980 University Ave, Halifax, B3K 6R8, Nova Scotia

[2] Department of Orthopaedic Surgery, University of Calgary, 2500 University Dr. NW, Calgary, T2N 1N4, Alberta

[3] Department of Radiology, Surrey Memorial Hospital, 13750 96 Ave, Surrey, V3V 1Z2, British Columbia

来源：

Spine Deformity | 2018年 / 6卷 / 4期

关键词：

Scoliosis; Thoracoscopic spine surgery; Thoracoscopy; Vertebral body tethering;

D O I：

10.1016/j.jspd.2017.12.013

中图分类号：

学科分类号：

摘要：

Study Design: A systematic review and meta-analysis on thoracoscopic anterior instrumentation and fusion as a treatment for adolescent idiopathic scoliosis (AIS). Objective: The goal of this study is to determine the current status of thoracoscopic instrumentation and fusion as a treatment for AIS. Summary of Background Data: Traditional surgical techniques for AIS have been open anterior thoracotomy with instrumentation and posterior spinal fusion and instrumentation. With the growing clinical interest in growth modulation surgeries, such as vertebral body tethering, there is a resurgence of interest in a thoracoscopic technique. Methods: The most commonly used medical databases (PubMed, Medline, EMBASE, CINAHL, and the Cochrane library) were searched up to November 2016 using the search terms VATS, thoracoscopic scoliosis, and thoracoscopic scoliosis instrumentation. Results: Thirteen studies met the strict inclusion criteria. Five hundred thirty patients were reported: 81.7% females, with the majority diagnosed as AIS. The mean operative time was 371.5 minutes, mean blood loss of 502.85 mL, and mean hospital stay of 5.9 days. Mean preoperative curve magnitude was 52.9°; postoperative curve magnitude was 17.9° with a correction of 62.7%. Number of levels instrumented was 6.3, pulmonary function tests returned to preoperative values by 2 years postoperation, and the complication rate was 21.3%. Compared to thoracotomy, VATS had similar complication rates, blood loss, operation theater time, curve correction, and number of fused levels. Compared to posterior fusion, VATS has higher complication rates and operation theater time. Blood loss and percentage correction were similar. VATS had a smaller number of fused segments. Conclusions: Advantages include less invasive, excellent curve correction, few levels fused, good satisfaction, and no long-term effect on pulmonary function. Drawbacks are increased operative time and incidence of pulmonary complications. With appropriate surgeon training and careful patient selection, this technique offers an acceptable alternative to the more traditional procedures. Level of Evidence: Level II. © 2017 Scoliosis Research Society

引用

页码：384 / 390

页数：6

共 36 条

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