[Clinical outcome of anterior corrective surgery for thoracolumbar scoliosis: mini-open approach without diaphragm dissection versus open approach].
OBJECTIVE
To investigate the feasibility and clinical results of a new mini-open approach in the anterior instrumentation of thoracolumbar scoliosis by comparing with traditional open approach.


METHODS
Seventy-two patients with the idiopathic thoracolumbar scoliosis underwent one stage anterior instrumentation and spinal fusion. In group A, the patients received anterior mini-open approach without dissecting diaphragm. There were total 34 cases with average age of 16 years old, ranging from 12 to 25 years. The average Cobb angle was 58 degrees with a range of 42 degrees to 76 degrees pre-operatively. The instrumentation levels were from T(11) to L(3) in 18 cases, T(11) to L(2) in 6 cases, T(11) to L(4) in 10 cases. In group B, the patients were treated with traditional open approach. Total 38 cases with average age of 17 years old, ranging from 13 to 26 years, were included. The average Cobb angle was 54 degrees with a range of 40 degrees to 74 degrees pre-operatively. The instrumentation levels were from T(10) to L(3) 7 cases, T(11) to L(3) 20 cases, T(11) to L(4) 11 cases.


RESULTS
In group A, the average curve correction was 81% with post-operative Cobb angle 12 degrees ranging from 4 to 16 degrees . Sagittal alignment restoration was satisfied in this group. In group B, the average curve correction was 73% with post-operative Cobb angle 15 degrees . The rehabilitation time was shorter in group A than in group B. No death, vascular injury and neurological complication occurred. Exudative pleurisy occurred in two patients in each group and cured very well.


CONCLUSIONS
Mini-open anterior instrumentation for thoracolumbar scoliosis without diaphragm dissection is proved to have the same outcomes as the traditional anterior approach, without the increase of complication.
Qiu
Yong
Y
Spinal Service, Gulou Hospital, Nanjing University School of Medicine, Nanjing 210008, China. qiuyong@jlonline.com
Wang
Bin
B
Zhu
Feng
F
Yu
Yang
Y
Zhu
Ze-zhang
ZZ
Zhu
Li-hua
LH
D000293:Adolescent; D000328:Adult; D002648:Child; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome