Thoracoscopic Techniques for the Treatment of Scoliosis: Early Results in Procedure Development

Picetti, George D.; Pang, Dachling; Bueff, H. Ulrich

doi:10.1097/00006123-200210000-00023

Cited by 42 publications

(43 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postoperative pain and scar formation decrease in patients with the introduction of the videoassisted thoracoscopic surgery (76,92). Potter compared anterior and posterior fusion for thoracic curves and reported that posterior approach achieved better correction compared to the anterior approach (73).…”

Section: Anterior Instrumentationmentioning

confidence: 99%

Idiopathic scoliosis

Yaman¹,

Dalbayrak²

2013

Turkish Neurosurgery

View full text Add to dashboard Cite

Scoliosis refers to curves exceeding 10 degrees observed through posterioanterior direct radiography. In fact, the diagnosis for idiopathic scoliosis is accepted to exclude already available causes. The aim of this paper was to review the etiopathogenesis, classification systems and the treatment management of idiopathic scoliosis. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' was performed. For the literature review, papers concerning the etiopathogenesis, classification and treatment were selected among these articles. A search in the National Library of Medicine (Pubmed) database using the key words 'idiopathic' and 'scoliosis' yielded 4518 articles published between 1947 and 2013. The main hypothesis put forward included genetic factors, hormonal factors, bone and connective tissue anomalies. King, Lenke, Coonrad and Peking Union Medical College (PUMC) classifications were the main classification systems for idiopathic scoliosis. Exercise, bracing and anterior, posterior or combined surgery when indicated are the choices for the treatment. Every idiopathic scoliosis case has to be managed to its own characteristics. It is the post-operative appearance that the surgeons are perhaps the least interested but the adolescent patients the most interested in. The aim of scoliosis surgery is to restore the spine without neurological deficit.

show abstract

Section: Anterior Instrumentationmentioning

confidence: 99%

Idiopathic scoliosis

Yaman¹,

Dalbayrak²

2013

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…29,65 Thoracoscopic spine surgery has also made treatment of hyperhidrosis possible in a minimally invasive way. Picetti, et al, 61 performed corrective surgery with the aid of a thoracoscope in 50 patients with thoracic scoliosis. Endoscopic instrumentation was successfully performed in all patients.…”

Section: Neurosurg Focus / Volume 16 / January 2004mentioning

confidence: 99%

Minimally invasive spinal surgery: a historical perspective

Thongtrangan¹,

Le²,

Park³

et al. 2004

FOC

View full text Add to dashboard Cite

The concept of minimally invasive spinal surgery embodies the goal of achieving clinical outcomes comparable to those of conventional open surgery, while minimizing the risk of iatrogenic injury that may be incurred during the exposure process. The development of microscopy, laser technology, endoscopy, and video and image guidance systems provided the foundation on which minimally invasive spinal surgery is based. Minimally invasive treatments have been undertaken in all areas of the spinal axis since the 20th century. Lumbar disc disease has been treated using chemonucleolysis, percutaneous discectomy, laser discectomy, intradiscal thermoablation, and minimally invasive microdiscectomy techniques. The initial use of thoracoscopy for thoracic discs and tumor biopsies has expanded to include deformity correction, sympathectomy, vertebrectomy with reconstruction and instrumentation, and resection of paraspinal neurogenic tumors. Laparoscopic techniques, such as those used for appendectomy or cholecystectomy by general surgeons, have evolved into procedures performed by spinal surgeons for anterior lumbar discectomy and fusion. Image-guided systems have been adapted to facilitate pedicle screw placement with increased accuracy. Over the past decade, minimally invasive treatment of cervical spinal disorders has become feasible by applying technologies similar to those developed for the thoracic and lumbar spine. Endoscope-assisted transoral surgery, cervical lam-inectomy, discectomy, and foraminotomy all represent the continual evolution of minimally invasive spinal surgery. Further improvement in optics and imaging resources, development of biological agents, and introduction of instrumentation systems designed for minimally invasive procedures will inevitably lead to further applications in minimally invasive spine surgery.

show abstract

“…Our results showed that end-to-end fusions from anterior approach are not necessary. Pseudarthrosis and implant failures were reported in thoracoscopic-assisted technique with end-to-end fusions [4,11,12]. Complete disc removal, end plate osteotomies and compression of the osteotomised vertebral endplates promoted rapid fusion which was the reason why we did not have any pseudarthrosis nor implant breakage in our series.…”

Section: Discussionmentioning

confidence: 51%

“…Without the complete removal of the intervertebral discs the fusions need to be done from the upper end to lower end of the scoliosis curve [4]. Pseudarthrosis and implant failures were also reported [11,12]. The length of standard thoracotomy exposure, the length of spinal fusion and the bulk of anterior implants may be contributing factors for the postoperative reduction of pulmonary function [13,14].…”

Section: Introductionmentioning

confidence: 99%

Anterior short correction in thoracic adolescent idiopathic scoliosis with mini-open thoracotomy approach: prospective clinical, radiological and pulmonary function results

et al. 2012

View full text Add to dashboard Cite

Introduction This is a prospective study of adolescent patients in whom idiopathic thoracic scoliosis was corrected by short anterior fusion through a mini-open thoracotomy approach. Clinical, radiological and pulmonary function results of minimal 2-year (2-6) follow-up are presented. Materials and methods Consecutive 62 patients with Lenke 1 and 2 curves, having main thoracic scoliosis of up to 75°, were prospectively included. The shoulder imbalance in Lenke 2 patients was less than 20 mm. Thoracic scoliosis was corrected by short anterior fusion. The thoracic spine was exposed by an 8-cm mini-open thoracotomy incision. The operation technique and choosing of fusion levels are thoroughly described. Complete 360°discectomies and convex side vertebral endplates osteotomies are essential for deformity corrections with short fusions. Single-rod 5.5-mm titanium implants were used. The age at the time of operation was mean 15.2 years; 56 patients had a single thoracic curve and 6 patients had a double thoracic curve. There were almost equal numbers of patients with lumbar modifier A, B or C. The average length of fusion was 5.5 (4-7) vertebrae. The average length of fusion was 3.5 (2-6) vertebrae shorter than the average curve length. Results The instrumented thoracic curves improved by 58.3% at 6 weeks and 56.3% at the last follow-up. Apex thoracic vertebral rotation improved by 73.78% at 6 weeks and 76.24% at the last follow-up. The non-instrumented upper thoracic curve improved by 25% in double thoracic scoliosis, where the mid-thoracic curve was selectively fused, and the non-instrumented lumbar curves improved by 33.9% at the last follow-up. The radiological changes from 6 weeks to the last follow-up were statistically not significant. The clinical rib hump improved by 54% at the last follow-up. There were no significant changes in the pulmonary function. FVC% was 81.04% preoperatively, 76.41% at 6 months and 80.38% at the 2-year follow-up. The results of SRS 24 questionnaire improved from a total of 61.40 points preoperatively to 100.50 points at 6 months and 98.62 points at the 2-year follow-up. There were no neurological or thoracotomy related complications, no pseudarthrosis, no implant pullout or breakage. Conclusion A good deformity correction without loss of correction or adding on, a good cosmetic result and good patient's satisfaction were achieved through shorter than end-to-end thoracic fusions. The radiological residual deformity is acceptable. Anterior correction of thoracic scoliosis with a short spinal fusion is recommended to keep the large part of the spine mobile. A very short fusion, small thoracotomy incision, low-profile implants and complete closure of parietal pleura are keys to prevent reduction in postoperative lung function.

show abstract

Thoracoscopic Techniques for the Treatment of Scoliosis: Early Results in Procedure Development

Cited by 42 publications

References 1 publication

Idiopathic scoliosis

Idiopathic scoliosis

Minimally invasive spinal surgery: a historical perspective

Anterior short correction in thoracic adolescent idiopathic scoliosis with mini-open thoracotomy approach: prospective clinical, radiological and pulmonary function results

Contact Info

Product

Resources

About