RESULTS OF VIDEO-ASSISTED EXPOSURE OF THE ANTERIOR THORACIC SPINE IN IDIOPATHIC SCOLIOSIS

Background. The feasibility of a video-assisted anterior approach to t he thoracic spine has recently been reported for a variety of spine di sorders. This study compares the outcomes of the video-assisted and th oracotomy approaches. Methods. A consecutive series of 42 patients und erwent video-assisted thoracic surgical anterior release and were eval uated for degree of correction reported as a change in spine curvature and pulmonary functions reported as a percent of predicted values. Th ey were followed up for a minimum of 1 year and compared with historic controls. Results. There was no significant difference in the percent age of correction between the video-assisted and thoracotomy groups, a nd the angle of correction was stable over the period of follow-up. No statistically significant difference was noted for any lung volume me asure except for postoperative residual volume/total lung capacity rat io (video-assisted thoracic surgery 135 +/- 16.2; thoracotomy = 147.7 +/- 17.8; p = 0.03). This marginal difference becomes more significant when severely affected patients are analyzed separately (p < 0.01). C onclusions. The video-assisted anterior spine release achieves equival ent results in idiopathic scoliosis compared with an open approach. Th e preservation of chest wall musculature in severely affected patients appears to play a role in limiting the deterioration in postoperative pulmonary function.