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THE EFFICACY OF VIDEO ASSISTED THORACOSCOPIC SURGERY FOR ANTERIOR RELEASE AND FUSION IN THE MANAGEMENT OF PAEDIATRIC SPINAL DEFORMITIES



Abstract

This study examined clinical and radiological outcomes following video assisted thoracoscopic surgery (VATS) for anterior release and fusion in the correction of paediatric scoliotic deformities. Nineteen patients who underwent VATS were compared with nineteen open thoracotomy patients to compare degree of correction and perioperative morbidity. Demographic parameters were similar between the groups and there was no significant difference in operative time or total blood loss. VATS offered the same degree of correction as open thoracotomies and has the potential to decrease post-operative morbidity while still allowing the same degree of correction as traditional open thoracotomies.

To compare the peri-operative parameters and outcomes of video-assisted thoracoscopic surgery (VATS) with open thoracotomy for anterior release and fusion in the treatment of paediatric spinal deformities.

VATS is a good alternative to open thoracotomy.

VATS has the potential to decrease post-operative morbidity while still allowing the same degree of correction as traditional open thoracotomies.

There were nineteen patients in each group, seventeen with idiopathic scoliosis in the VATS group and sixteen in the open group. Mean age, weight at surgery and pre-operative Cobb angle were similar (p=1.000, 0.8277, 0.0636, respectively). There was no significant difference in operative time per level between the VATS group and the open group (37.2 vs. 34.5 min, p= 0.2254) or total blood loss (908 vs. 823 ml, p= 0.4953). There were no major complications encountered in the VATS group, one patient in the open group experienced atelectasis and subsequent lower lobe collapse.

A detailed chart and radiographic review was undertaken to determine degree of correction, perioperative morbidity and complications, if any, of patients who underwent VATS between 1997 and 2004 at the author’s institution. A control group of patients who underwent open thoracotomy was used to determine if is there a significant difference in correction (Cobb angle) or in perioperative morbidity when using VATS versus open thoracotomy for anterior release and fusion in the correction of scoliotic deformities.

It appears that VATS offers the same degree of correction as open thoracotomies.

Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada