title: Minimally Invasive Scoliosis Surgery: A Novel Technique in Patients with Neuromuscular Scoliosis.
abstract: Minimally invasive surgery (MIS) has been described in the treatment of adolescent idiopathic scoliosis (AIS) and adult scoliosis. The advantages of this approach include less blood loss, shorter hospital stay, earlier mobilization, less tissue disruption, and relatively less pain. However, despite these significant benefits, MIS approach has not been reported in neuromuscular scoliosis patients. This is possibly due to concerns with longer surgery time, which is further increased due to more levels fused and instrumented, challenges of pelvic fixation, size and number of incisions, and prolonged anesthesia. We modified the MIS approach utilized in our AIS patients to be implemented in our neuromuscular patients. Our technique allows easy passage of contoured rods, placement of pedicle screws without image guidance, partial/complete facet resection, and all standard reduction maneuvers. Operative time needed to complete this surgery is comparable to the standard procedure and the majority of our patients have been extubated at the end of procedure, spending 1 day in the PICU and 5-6 days in the hospital. We feel that MIS is not only a feasible but also a superior option in patients with neuromuscular scoliosis. Long-term results are unavailable; however, short-term results have shown multiple benefits of this approach and fewer limitations.
authors.affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Sarwahi
authors.affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Terry
authors.initials: T
authors.lastname: Amaral
authors.affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Wendolowski
authors.affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Gecelter
authors.affiliation: Division of Pediatric Orthopedics, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Gambassi
authors.affiliation: Department of Orthopaedic Surgery, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA.
authors.forename: Christos
authors.initials: C
authors.lastname: Plakas
authors.affiliation: Department of Pediatric Anesthesiology, Cohen Children's Medical Center, New Hyde Park, NY 11040, USA.
authors.forename: Benita
authors.initials: B
authors.lastname: Liao
authors.affiliation: Division of Pediatric Cardiology, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA.
authors.forename: Sarika
authors.initials: S
authors.lastname: Kalantre
authors.affiliation: Division of Critical Care, Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, NY 10467, USA.
authors.forename: Chhavi
authors.initials: C
authors.lastname: Katyal
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010149:Postoperative Pain; D065289:Pedicle Screws; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery