RESPIRATORY FUNCTION AND ENDOSCOPIC SCOLIOSIS SURGERY

Abstract

Introduction: Endoscopic techniques are an established technique for anterior correction and instrumentation of thoracic scoliosis. Deterioration in respiratory function post thoracotomy for has been cited as a disadvantage of anterior approaches and led certain authors to recommend posterior methods¹. Endoscopic techniques may reduce respiratory complications and respiratory compromise in both the short and long term.

Methods: Thirty eight patients, 7 male 31 female, mean age 17.3 yrs (11– 37yrs) have undergone endoscopic scoliosis surgery under the senior author. Indication for surgery was idiopathic scoliosis 36 and an underlying syrinx 2. All patients undergoing endoscopic scoliosis surgery have a standard preoperative assessment including respiratory function tests (RFTs). All patients have been followed up prospectively (mean 15 months, range 3 – 33 months) and standard data recorded. As part of this study we are in the process of performing follow up RFTs on all patients.

Results: Preoperatively no significant respiratory function compromise attributable to the scoliosis has been detected. Mean duration of intercostal drain was 2 days, one patient requiring reinsertion for a recurrent pneumothorax. No other major respiratory complication occurred. On average patients were fully mobile by day five and mean hospital stay was 6 days (4–10 days). Provisional RFTs postoperatively have shown no significant change.

Discussion: Our provisional results indicate that endoscopic scoliosis correction and instrumentation does not lead early respiratory complications or to a significant deterioration in respiratory function of the patient.