title: Use of video-assisted thoracoscopic surgery to reduce perioperative morbidity in scoliosis surgery.
abstract: METHODS
  A case series of idiopathic scoliosis patients treated with thoracoscopic anterior instrumentation was compared to a similar group of patients treated by open anterior instrumentation.
  
  
  OBJECTIVE
  To evaluate the morbidity associated with thoracoscopic instrumentation compared to the open approach for thoracic scoliosis.
  
  
  METHODS
  A consecutive group of thoracoscopically treated patients with Lenke 1 adolescent idiopathic scoliosis was compared to similar patients gathered from the DePuy-AcroMed Harms Study Group database. Perioperative outcome measures as well as early postoperative functional outcomes (pulmonary function, shoulder strength) were compared.
  
  
  RESULTS
  There were 38 thoracoscopic instrumentation cases with greater than 6 months' follow-up that were compared to 68 anterior open instrumentation cases. The radiographic outcomes were similar (60% +/- 11% vs. 59% +/- 17% thoracic curve correction for the thoracoscopic and open groups, respectively). The reduction in forced vital capacity was significantly (P = 0.01) greater in the open group (0.6 +/- 0.3 L) compared to the endoscopic group (0.4 +/- 0.3 L). There was a trend towards greater return of shoulder girdle strength and range of motion 6 weeks after surgery in the thoracoscopic patients.
  
  
  CONCLUSIONS
  The thoracoscopic approach for instrumentation of scoliosis has advantages of reduced chest wall morbidity compared with the open thoracotomy method but allows comparable curve correction.
authors.affiliation: Children's Hospital and Health Center, San Diego, CA, USA. pnewton@chsd.org
authors.forename: Peter O
authors.initials: PO
authors.lastname: Newton
authors.forename: Michelle
authors.initials: M
authors.lastname: Marks
authors.forename: Frances
authors.initials: F
authors.lastname: Faro
authors.forename: Randy
authors.initials: R
authors.lastname: Betz
authors.forename: David
authors.initials: D
authors.lastname: Clements
authors.forename: Tom
authors.initials: T
authors.lastname: Haher
authors.forename: Larry
authors.initials: L
authors.lastname: Lenke
authors.forename: Tom
authors.initials: T
authors.lastname: Lowe
authors.forename: Andrew
authors.initials: A
authors.lastname: Merola
authors.forename: Dennis
authors.initials: D
authors.lastname: Wenger
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D015203:Reproducibility of Results; D012600:Scoliosis / Q000473:pathology / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome