Prospective pulmonary function comparison of open versus endoscopic anterior fusion combined with posterior fusion in adolescent idiopathic scoliosis

Lawrence G. Lenke, Peter O. Newton, Michelle C. Marks, Kathy M. Blanke, Brenda Sides, Yongjung J. Kim, Keith H. Bridwell

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Study Design. Prospective clinical study. Objective. To evaluate pulmonary function tests at a minimum 2-year follow-up in patients with adolescent idiopathic scoliosis (AIS) undergoing either an endoscopic versus open anterior fusion along with posterior segmental fixation and fusion. Methods. A total of 21 patients with AIS underwent a video-assisted thoracoscopic (VAT group) release/fusion followed by a posterior spinal fusion (PSF) and segmental spinal fixation were compared to 16 patients who underwent an open thoracotomy (Open group) followed by a PSF. The mean preoperative thoracic Cobb was 70° in the VAT group versus 75° in the Open group. All patients had preoperative and a minimum 2-year postoperative pulmonary function tests consisting of forced vital capacity (FVC) forced expiratory volume in one second (FEV-1). Results. The average thoracic Cobb correction was to 27° (61%) in the VAT group versus 36° (52%) in the Open group. Preoperative and 2-year postoperative FVC in the VAT group averaged 2.48 L and 2.85 L, respectively (P = 0.006). The Open group corresponding results were 1.97 L and 2.43 L, respectively (P = 0.0011. Preoperative and minimum 2-year postoperative FEV-1 in the VAT group averaged 2.06 L and 2.37 L, respectively (P = 0.005). Values for the Open group were 1.65 L and 2.08 L, respectively (P = 0.001). Although both groups had pulmonary function test parameters that were statistically improved postoperative versus preoperative, there were no significant differences comparing the VAT group to the Open group (P > 0.05) Conclusions. VAT versus Open release/anterior fusion in association with a PSF for select AIS curves requiring circumferential treatment both demonstrated similar radiographic and pulmonary function test improvement at 2 years postoperative, with no significant differences seen between the groups.

Original languageEnglish
Pages (from-to)2055-2060
Number of pages6
JournalSpine
Volume29
Issue number18
DOIs
StatePublished - Sep 15 2004

Keywords

  • Adolescent idiopathic scoliosis
  • Anterior spinal fusion
  • Open thoracotomy
  • Posterior spinal fusion
  • Pulmonary function tests
  • Thoracoscopic anterior fusion

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