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Ann Thorac Surg 1996;62:818-822
© 1996 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Results of Video-Assisted Exposure of the Anterior Thoracic Spine in Idiopathic Scoliosis

Marc E. Pollock, MD, Kelly O'Neal, MD, George Picetti, MD, Ronald Blackman, MD

Department of Cardiothoracic Surgery, University of California, Davis, Medical Center, Sacramento, and Kaiser Permanente, Oakland, California

See also page 822.

Background. The feasibility of a video-assisted anterior approach to the thoracic spine has recently been reported for a variety of spine disorders. This study compares the outcomes of the video-assisted and thoracotomy approaches.

Methods. A consecutive series of 42 patients underwent video-assisted thoracic surgical anterior release and were evaluated for degree of correction reported as a change in spine curvature and pulmonary functions reported as a percent of predicted values. They were followed up for a minimum of 1 year and compared with historic controls.

Results. There was no significant difference in the percentage of correction between the video-assisted and thoracotomy groups, and the angle of correction was stable over the period of follow-up. No statistically significant difference was noted for any lung volume measure except for postoperative residual volume/total lung capacity ratio (video-assisted thoracic surgery = 135 ± 16.2; thoracotomy = 147.7 ± 17.8; p = 0.03). This marginal difference becomes more significant when severely affected patients are analyzed separately (p < 0.01).

Conclusions. The video-assisted anterior spine release achieves equivalent results in idiopathic scoliosis compared with an open approach. The preservation of chest wall musculature in severely affected patients appears to play a role in limiting the deterioration in postoperative pulmonary function.


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Discussion
Ann. Thorac. Surg. 1996 62: 822-823. [Extract] [Full Text]



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