Abstract
Introduction The purpose of this study is to present the results of the fi rst 28 cases operated on by one of the authors.
Methods The 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 was collected pre-operatively and at six weeks, three months, 12 months and 24 months post-operatively. The series comprises 27 females and one male. The median age was 18 years (range 10 to 46). A median of four portals was used (range 3 to 5), six discs were excised (range 4 to 8) and seven levels were instrumented (range 5 to 9). Operating time was a median of 5.5 hours (range 4 to 7). Median blood loss was 450 ml (range 20 to 2000 ml).
Results Rib humps were corrected from a mean of 160° to 60°. The Cobb angle was converted from a mean of 55° to a mean of 21°: a correction rate of 62%. Sagittal alignment has improved: the sagittal plumb line moving a mean of two centimetres anteriorly. A significant improvement in outcome from a pre-op median of 59 to a post op median of 67 as measured by the SRS instrument has been observed. Follow-up is for a mean of 12 months (range 1 to 25). There has been one case of rod breakage at one year. This has not affected the clinical outcome and this case has now been followed for two years. There has been one case of frozen shoulder involving the dependant intra-operative shoulder that resolved after several months. There has been no blood transfusion and no loss of correction in any case to date.
Conclusions The thoracoscopic technique has proven safe and effective. A more cosmetic wound is achieved and the trunk muscles are spared. One or two levels in the thoraco-lumbar spine are spared from fusion.
In relation to the conduct of this study, one or more of the authors is in receipt of a research grant from a non-commercial source.
The abstracts were prepared by Mr Jerzy Sikorski. Correspondence should be addressed to him at the Australian Orthopaedic Association, Ground Floor, William Bland Centre, 229 Macquarie Street, Sydney NSW 2000, Australia.
