|Beitragstitel||Minimally Invasive Sur^gery for Adolescent Idiopathic Scoliosis: Deformity Correction and Perioperative Morbidity in 70 Consecutive Patients|
Introduction: Minimally invasive surgery (MIS) has been recently described for adolescent idiopathic scoliosis (AIS) with current data available based on a limited number of patients. Our primary aim was to evaluate deformity correction and perioperative morbidity in a larger group. Secondary aims included evaluation of operative time (ORT), estimated blood loss (EBL), length of stay (LOS) and additional complication.
Methods: Consecutive AIS patients treated with a MIS technique at 2 tertiary centers (Geneva and Lausanne University hospitals) from June 2013 to February 2016 were retrospectively included. Pre-operative patient and deformity characteristics, perioperative parameters, power of deformity correction, and complications were studied.
Results: 70 AIS patients were included (female=62, age 15 ± 4.5 years, BMI 19.8 ± 5.4 kg/m2). ORT averaged 337 ± 121 min. Preoperative major Cobb angle averaged 58.9 ± 12.6° and was significantly corrected to 17.7 ± 10.2° (69% curve correction, p<0.001). Preoperative T2-T12 kyphosis was 33.2 ± 13.7° and was significantly increased to 39.5 ± 11.4° (18% curve corrrection). Mean OR per level fused was 25 ± 5 min and decreased over the first 25 cases. Mean EBL was 346 ± 175 ml representing 36 ml ± 14 per level. Mean of screws used was 18.6 ± 4.1. Mean number of levels fused was 11.2 ± 4.9, representing 30 minutes of ORT per level. Average LOS was 4.6 ± 0.8 days. Perioperative (30 days) complication rate was 4.2 %: 1 subcutaneous hematoma, 1 deep venous thrombosis, and 1 pulmonary complication. Five (7.1 %) additional complications occurred in 5 patients at a mean follow-up of 2 years (41 patients have minimum 2 years follow-up): 1 superficial wound infection, 1 suture granuloma, and 3 delayed deep surgical site infections.
Conclusion: MIS for AIS is associated with a significant correction of spine deformity in frontal and sagittal planes, together with low EBL and short LOS. Perioperative complication rate seems to be similar to standard open technique. The longer-term safety of MIS procedure for AIS needs to be documented with further follow-up of a larger cohort.