Abstract
Open anterior surgery, including release and instrumentation, is a widely used technique for correction of dorsal and dorsolumbar curves. In the past we have used various different devices to maintain correction. These include Dwyer cable, Zeilke rods, Webb-Morley rods, vertebral staples and the Kaneda system. Any of these can be combined with posterior correction, stabilization and grafting. Several of these techniques have been successfully adapted for the treatment of our cases in Egypt. We encounter severe deformities due to their late presentation.
Over the last five years we have used anterior endoscopic release. All had posterior instrumentation.
Results: We did anterior release in 20 scoliosis cases and corpectomy in 10 cases. These were compared with another twenty cases who were treated by open anterior and posterior surgery.
The results are very encouraging regarding degree of correction; hospital stay; and costs as compared with our historical series of conventional two-stage surgery. There are a number of constraints on using endoscopic techniques. Surgeons require long training and close co-operation. It is contraindicated in those cases with adhesions and patients unfit for one lung anaesthesia. We found the technique is safe and effective. We recommend it for treatment of rigid curves to gain good results and to reduce hospital costs.
Correspondence should be addressed to Jeremy C T Fairbank at The Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX7 7LD, UK
