Video-assisted anterior thoracoscopic spinal fusion versus posterior spinal fusion: a comparative study utilizing the SRS-22 outcome instrument.
METHODS
Retrospective, matched cohort.


OBJECTIVE
The purpose of this study was to compare the Scoliosis Research Society's Outcomes measures (SRS-22) scores, as well as radiographic outcomes of patients with adolescent idiopathic scoliosis who had a single thoracic structural curvature treated by either posterior spinal fusion (PSF) or video-assisted thoracoscopic (VATS) fusion.


BACKGROUND
To our knowledge, there has been no prior matched-pair study comparing outcomes between 2 different surgical approaches for the same curve type using the SRS-22 outcomes instrument.


METHODS
Patients were evaluated before surgery and at 2-year follow-up. A total of 52 patients with Lenke type I curvature were paired by age, gender, and major Cobb angle into 2 groups: PSF (8 men, 18 women, mean age 14.7, mean Cobb angle 48.7) and VATS (mean age 14.8, mean Cobb angle 49.1). All questionnaire scores were classified based on domains of activity, pain, self-image, mental health, satisfaction, and total scores.


RESULTS
The patients in the VATS group scored higher than the PSF group in the domains of self-image (P < 0.02), mental health (P < 0.03), and total score (P < 0.05), but not activity, pain, or satisfaction at 2 years. There was no difference in percent curve correction between the match-paired groups. Within-group analyses revealed that VATS patients experienced insignificant improvements compared with PSF in most SRS-22 domains and a trend toward significant overall mean score improvement (P = 0.06).


CONCLUSIONS
Based on the SRS-22 questionnaire data, the VATS patients scored higher in the self-image, mental health, and total domains despite similar curve corrections. We hypothesize that this may be related to the smaller surgical scar and less invasive nature of VATS.
Lonner
Baron S
BS
Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, NY, USA. blonner@nyc.rr.com
Auerbach
Joshua D
JD
Estreicher
Michael
M
Milby
Andrew H
AH
Kean
Kristin E
KE
Panagopoulos
Georgia
G
Chang
David
D
D000293:Adolescent; D002921:Cicatrix / Q000517:prevention & control / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012647:Self-Assessment; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013904:Thoracic Vertebrae / Q000601:surgery*; D013906:Thoracoscopy / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014741:Video Recording / Q000379:methods