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Related Experiment Videos

Defining the pediatric spinal thoracoscopy learning curve: sixty-five consecutive cases.

P O Newton1, K G Shea, K F Granlund

  • 1Children's Hospital San Diego, California, USA. pnewton@chsd.org

Spine
|April 18, 2000
PubMed
Summary

This study defines the learning curve for spinal thoracoscopy in pediatric spinal deformity treatment. While substantial, the learning curve is not prohibitive, showing thoracoscopy is a safe alternative to open surgery.

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Area of Science:

  • Spine Surgery
  • Pediatric Orthopedics
  • Minimally Invasive Procedures

Background:

  • Thoracoscopy offers an alternative to open thoracotomy for pediatric spinal deformity.
  • The learning curve for spinal thoracoscopy has not been previously described.

Purpose of the Study:

  • To define the learning curve associated with spinal thoracoscopy.
  • To evaluate the efficacy and safety of thoracoscopic anterior release with discectomy and fusion in pediatric spinal deformity.

Main Methods:

  • Prospective review of 65 consecutive cases of thoracoscopic anterior release, discectomy, and fusion.
  • Patients averaged 14 years old with diagnoses including idiopathic scoliosis, Scheuermann's kyphosis, and neuromuscular spinal deformity.
  • Data collected included operative time, discs excised, blood loss, and radiographic correction.

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Main Results:

  • Average operative time decreased significantly per disc excised as the surgeon's experience grew (29.3 min/disc vs. 22.3 min/disc, P < 0.01).
  • Initial correction rates for scoliosis and kyphosis were 59% and 92%, respectively.
  • Complications occurred in 6 patients and were distributed throughout the series.

Conclusions:

  • The learning curve for spinal thoracoscopy is significant but manageable.
  • Spinal thoracoscopy is a safe and effective alternative to thoracotomy for treating pediatric spinal deformities.