Thoracoscopic anterior instrumented fusion for adolescent idiopathic scoliosis with emphasis on the sagittal plane

Baron S. Lonner, Joshua D. Auerbach, Rafael Levin, David Matusz, Carrie L. Scharf, Georgia Panagopoulos, Alok D. Sharan

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background context: Anterior fusion through an open thoracotomy restores kyphosis more reliably than posterior techniques in patients with thoracic adolescent idiopathic scoliosis (AIS). Video-assisted thoracoscopic spinal fusion and instrumentation (VATS) minimizes the morbidity, from soft tissue and muscle dissection that accompanies traditional open thoracotomy. To our knowledge, there has not been a comprehensive analysis of VATS with respect to radiographic and clinical outcomes in the sagittal plane. Purpose: To measure the radiographic and clinical outcomes after VATS with emphasis on the sagittal plane. Study design/setting: A retrospective, radiographic review of 26 consecutive patients with Lenke type-I AIS who underwent VATS. Methods: Radiographs of 26 consecutive patients with Lenke type-I AIS curves operated by a single surgeon were retrospectively reviewed after VATS. Sagittal and coronal parameters were compared with reported data for open anterior and posterior procedures. Results: There was an increase in kyphosis from baseline to final follow-up by 6.6° (25%) from T2 to T12 (p<.0001), 8.7° (50%) from T5 to T12 (p<.0001), and 8° (54%) in the instrumented segment (p<.0001). Junctional kyphosis did not occur. No differences were detected in sagittal measurements between the first postoperative erect and the final radiographs. Patients experienced significant improvements from baseline to 2 years in Scoliosis Research Society-22 Health-Related Quality-of-Life Outcome Questionnaire scores (p<.0001). Conclusions: Video-assisted thoracoscopic spinal fusion and instrumentation, in agreement with results reported for open anterior instrumentation, reliably restores or increases thoracic kyphosis while preserving junctional alignment in thoracic AIS.

Original languageEnglish (US)
Pages (from-to)523-529
Number of pages7
JournalSpine Journal
Volume9
Issue number7
DOIs
StatePublished - Jul 2009

Fingerprint

Spinal Fusion
Scoliosis
Kyphosis
Thorax
Thoracotomy
Dissection
Quality of Life
Morbidity
Muscles
Research

Keywords

  • Adolescent idiopathic scoliosis
  • Junctional kyphosis
  • Sagittal alignment
  • VATS

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Lonner, B. S., Auerbach, J. D., Levin, R., Matusz, D., Scharf, C. L., Panagopoulos, G., & Sharan, A. D. (2009). Thoracoscopic anterior instrumented fusion for adolescent idiopathic scoliosis with emphasis on the sagittal plane. Spine Journal, 9(7), 523-529. https://doi.org/10.1016/j.spinee.2008.11.005

Thoracoscopic anterior instrumented fusion for adolescent idiopathic scoliosis with emphasis on the sagittal plane. / Lonner, Baron S.; Auerbach, Joshua D.; Levin, Rafael; Matusz, David; Scharf, Carrie L.; Panagopoulos, Georgia; Sharan, Alok D.

In: Spine Journal, Vol. 9, No. 7, 07.2009, p. 523-529.

Research output: Contribution to journalArticle

Lonner, BS, Auerbach, JD, Levin, R, Matusz, D, Scharf, CL, Panagopoulos, G & Sharan, AD 2009, 'Thoracoscopic anterior instrumented fusion for adolescent idiopathic scoliosis with emphasis on the sagittal plane', Spine Journal, vol. 9, no. 7, pp. 523-529. https://doi.org/10.1016/j.spinee.2008.11.005
Lonner, Baron S. ; Auerbach, Joshua D. ; Levin, Rafael ; Matusz, David ; Scharf, Carrie L. ; Panagopoulos, Georgia ; Sharan, Alok D. / Thoracoscopic anterior instrumented fusion for adolescent idiopathic scoliosis with emphasis on the sagittal plane. In: Spine Journal. 2009 ; Vol. 9, No. 7. pp. 523-529.
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abstract = "Background context: Anterior fusion through an open thoracotomy restores kyphosis more reliably than posterior techniques in patients with thoracic adolescent idiopathic scoliosis (AIS). Video-assisted thoracoscopic spinal fusion and instrumentation (VATS) minimizes the morbidity, from soft tissue and muscle dissection that accompanies traditional open thoracotomy. To our knowledge, there has not been a comprehensive analysis of VATS with respect to radiographic and clinical outcomes in the sagittal plane. Purpose: To measure the radiographic and clinical outcomes after VATS with emphasis on the sagittal plane. Study design/setting: A retrospective, radiographic review of 26 consecutive patients with Lenke type-I AIS who underwent VATS. Methods: Radiographs of 26 consecutive patients with Lenke type-I AIS curves operated by a single surgeon were retrospectively reviewed after VATS. Sagittal and coronal parameters were compared with reported data for open anterior and posterior procedures. Results: There was an increase in kyphosis from baseline to final follow-up by 6.6° (25{\%}) from T2 to T12 (p<.0001), 8.7° (50{\%}) from T5 to T12 (p<.0001), and 8° (54{\%}) in the instrumented segment (p<.0001). Junctional kyphosis did not occur. No differences were detected in sagittal measurements between the first postoperative erect and the final radiographs. Patients experienced significant improvements from baseline to 2 years in Scoliosis Research Society-22 Health-Related Quality-of-Life Outcome Questionnaire scores (p<.0001). Conclusions: Video-assisted thoracoscopic spinal fusion and instrumentation, in agreement with results reported for open anterior instrumentation, reliably restores or increases thoracic kyphosis while preserving junctional alignment in thoracic AIS.",
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AU - Levin, Rafael

AU - Matusz, David

AU - Scharf, Carrie L.

AU - Panagopoulos, Georgia

AU - Sharan, Alok D.

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N2 - Background context: Anterior fusion through an open thoracotomy restores kyphosis more reliably than posterior techniques in patients with thoracic adolescent idiopathic scoliosis (AIS). Video-assisted thoracoscopic spinal fusion and instrumentation (VATS) minimizes the morbidity, from soft tissue and muscle dissection that accompanies traditional open thoracotomy. To our knowledge, there has not been a comprehensive analysis of VATS with respect to radiographic and clinical outcomes in the sagittal plane. Purpose: To measure the radiographic and clinical outcomes after VATS with emphasis on the sagittal plane. Study design/setting: A retrospective, radiographic review of 26 consecutive patients with Lenke type-I AIS who underwent VATS. Methods: Radiographs of 26 consecutive patients with Lenke type-I AIS curves operated by a single surgeon were retrospectively reviewed after VATS. Sagittal and coronal parameters were compared with reported data for open anterior and posterior procedures. Results: There was an increase in kyphosis from baseline to final follow-up by 6.6° (25%) from T2 to T12 (p<.0001), 8.7° (50%) from T5 to T12 (p<.0001), and 8° (54%) in the instrumented segment (p<.0001). Junctional kyphosis did not occur. No differences were detected in sagittal measurements between the first postoperative erect and the final radiographs. Patients experienced significant improvements from baseline to 2 years in Scoliosis Research Society-22 Health-Related Quality-of-Life Outcome Questionnaire scores (p<.0001). Conclusions: Video-assisted thoracoscopic spinal fusion and instrumentation, in agreement with results reported for open anterior instrumentation, reliably restores or increases thoracic kyphosis while preserving junctional alignment in thoracic AIS.

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