New instrumentation for video-assisted anterior spine release

Endoscopic surgery in the area of orthopedics has been evolving, particularly in spine surgery. We describe the clinical outcome of thoracoscopic anterior spine release using new instruments. A harmonic scalpel (HS) with a 5-mm hook dissector was used to dissect the spine and rib and to coagulate and transect the vascular bundles. A rib dissector and resector were used for excision of the rib to be implanted in the disk spaces. We treated scoliosis in four patients (three male, one female) with a mean age of 19.5 +/- 4.5 years and thoracolumbar kyphosis in a 16-year-old male patient. A mean number of 6.5 +/- 2.5 vertebrae with scoliosis and four vertebrae with kyphosis were released. In all cases, division of the vascular bundle and exposure of the spine were completed using only the HS, and excision of a rib segment was performed via a port incision using only the rib dissector and resector. The mean duration of thoracoscopic anterior release was 92 +/- 28 min. Blood loss was minimal during and after surgery. Thoracoscopic anterior spine release can be facilitated by the new instruments described above.