title: Video-Assisted Thoracoscopic Surgery and Minimal Access Spinal Surgery Compared in Anterior Thoracic or Thoracolumbar Junctional Spinal Reconstruction: A Case-Control Study and Review of the Literature.
abstract: There are no published reports that compare the outcomes of video-assisted thoracoscopic surgery (VATS) and minimal access spinal surgery (MASS) in anterior spinal reconstruction. We conducted a retrospective case-control study in a single center and systematically reviewed the literature to compare the efficacy and safety of VATS and MASS in anterior thoracic (T) and thoracolumbar junctional (TLJ) spinal reconstruction. From 1995 to 2012, there were 111 VATS patients and 76 MASS patients treated at our hospital. VATS patients had significantly (p< 0.001) longer operating times and significantly (p< 0.022) higher thoracotomy conversion rates. We reviewed 6 VATS articles and 10 MASS articles, in which there were 625 VATS patients and 399 MASS patients. We recorded clinical complications and a thoracotomy conversion rate from our cases and the selected articles. The incidence of approach-related complications was significantly (p= 0.021) higher in VATS patients. The conversion rate was 2% in VATS patients and 0% in MASS patients (p= 0.001). In conclusion, MASS is associated with reduction in operating time, approach-related complications, and the thoracotomy conversion rate.
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Meng-Huang
authors.initials: MH
authors.lastname: Wu
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yen-Yao
authors.initials: YY
authors.lastname: Li
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Cheng
authors.affiliation: Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
authors.forename: Chien-Yin
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Tsung-Jen
authors.identifier: 0000-0001-5021-2157
authors.initials: TJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013131:Spine / Q000000981:diagnostic imaging* / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*