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THORACOSCOPIC CORRECTION OF SCOLIOSIS : AN UPDATE



Abstract

Introduction: The purpose of this study is to present the current results of a series of 21 cases operated on over the past two years. This is the only series of this type in Australia to date. Although the technique was first reported four years ago, two year results have not been reported or published.

Methods: This study is a prospective single cohort study. The technique is applicable to approximately half of the adolescent idiopathic cases requiring surgery in a busy spinal deformity practice. Clinical radiological and patient derived outcome data are collected pre-operatively and at six weeks, three months, 12 months and 24 months post operatively.

Results: The series comprised 17 females and 1 male. Median age was 16 years (range 10–37). A median of four portals was used (range 3–5), six discs excised (range 4–8) and seven levels instrumented (range 5–9). Operating time was a median of 6 h (range 4.5–7). Median blood loss was 300 ml (range 20–2000). Mean intra-operative x-ray time was 160 s (range 130–190). Rib hump was corrected from a mean of 170 to 70. The Cobb angle was converted from a mean of 510 to a mean of 240, a correction rate of 52%. There has been no loss of correction in any case to date. Further to the minor complications outlined last year there has been one case of persistent postoperative deltoid pain from the dependant shoulder that resolved after several days.

Discussion: The thoracoscopic technique has proven safe and effective. A more cosmetic wound is achieved and one or two levels in the thoracolumbar spine are spared from fusion.

The abstracts were prepared by Dr Robert J. Moore. Correspondence should be addressed to him at The Spine Society of Australia, Institute of Medical and Veterinary Science, The Adelaide Centre for Spinal Research, Frome Road, Adelaide, South Australia 5000