VIDEO-ASSISTED THORACOSCOPIC DISKECTOMY AND FUSION

Thoracoscopic diskectomy has been described in adults as an alternativ e to thoracotomy for access to the anterior spine for correction of sc oliosis, but its use in children for correction of spinal deformities has not been reported. Eight patients have undergone video-assisted th oracoscopic diskectomy with fusion before posterior instrumentation. I n five patients, the posterior fusion and instrumentation followed the thoracoscopic procedure under the same anesthesia; in three patients it was staged and performed 1 week later, The mean time required for t he thoracoscopic procedure was 174 minutes, Intraoperative bleeding re quiring transfusion developed in one patient. No other complications o ccurred. The authors conclude that the minimally invasive approach for access to the thoracic cavity for anterior diskectomy and fusion will be the preferred approach because of the potential for significant re duction in postoperative discomfort and complications such as atelecta sis and pneumonia. postoperative hospitalization may not be decreased, however, because the patient must still recover from the open posteri or instrumentation and fusion operation. Copyright (C) 1997 by W.B. Sa unders Company.