title: Video-assisted thoracoscopic surgery plus lumbar mini-open surgery for adolescent idiopathic scoliosis.
abstract: OBJECTIVE
  The objectives of this study are to describe the outcome of adolescent idiopathic scoliosis (AIS) patients treated with Video Assisted Thoracoscopic Surgery (VATS) plus supplementary minimal incision in the lumbar region for thoracic and lumbar deformity correction and fusion.
  
  
  METHODS
  This is a case series of 13 patients treated with VATS plus lumbar mini-open surgery for AIS. A total of 13 patients requiring fusions of both the thoracic and lumbar regions were included in this study: 5 of these patients were classified as Lenke type 1A and 8 as Lenke type 5C. Fusion was performed using VATS up to T12 or L1 vertebral level. Lower levels were accessed via a small mini-incision in the lumbar area to gain access to the lumbar spine via the retroperitoneal space. All patients had a minimum follow-up of 1 year.
  
  
  RESULTS
  The average number of fused vertebrae was 7.1 levels. A significant correction in the Cobb angle was obtained at the final follow-up (p = 0.001). The instrumented segmental angle in the sagittal plane was relatively well-maintained following surgery, albeit with a slight increase. Scoliosis Research Society-22 (SRS-22) scores were noted have significantly improved at the final follow-up (p < 0.05).
  
  
  CONCLUSIONS
  Indications for the use of VATS may be extended from patients with localized thoracic scoliosis to those with thoracolumbar scoliosis. By utilizing a supplementary minimal incision in the lumbar region, a satisfactory deformity correction may be accomplished with minimal post-operative scarring.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyon Su
authors.initials: HS
authors.lastname: Chong
authors.forename: Hak Sun
authors.initials: HS
authors.lastname: Kim
authors.forename: Nanda
authors.initials: N
authors.lastname: Ankur
authors.forename: Phillip Anthony
authors.initials: PA
authors.lastname: Kho
authors.forename: Sung Jun
authors.initials: SJ
authors.lastname: Kim
authors.forename: Do Yeon
authors.initials: DY
authors.lastname: Kim
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Park
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Moon
authors.forename: Hwan Mo
authors.initials: HM
authors.lastname: Lee
authors.forename: Eun Su
authors.initials: ES
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012600:Scoliosis / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome