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Thoracoscopic anterior spinal procedures in children
S Rothenberg1, M Erickson, R Eilert
1The Children's Hospital, Denver, Colorado, USA.
Journal of Pediatric Surgery
|August 7, 1998
Summary
Thoracoscopic spinal surgery in pediatric patients is safe and effective, offering outcomes comparable to open surgery with reduced pain and shorter hospital stays. This minimally invasive approach benefits children with scoliosis and kyphosis.
Area of Science:
- Pediatric Orthopedic Surgery
- Minimally Invasive Spinal Procedures
- Adolescent Spinal Deformities
Background:
- Spinal deformities like scoliosis and kyphosis often require surgical intervention in pediatric patients.
- Traditional open spinal surgery can involve significant pain and prolonged recovery periods.
- Advancements in minimally invasive techniques offer potential benefits for pediatric spinal surgery.
Purpose of the Study:
- To evaluate the safety and efficacy of a thoracoscopic approach for anterior spinal surgery in pediatric patients.
- To compare outcomes of thoracoscopic spinal surgery with standard open techniques.
- To assess the impact of thoracoscopic surgery on patient recovery and morbidity.
Main Methods:
- A cohort of 20 pediatric patients (ages 8-17) with severe idiopathic/neurogenic scoliosis, kyphosis, or congenital hemivertebra underwent thoracoscopic anterior spinal procedures.
- Procedures included diskectomy, anterior release, hemivertebrectomy, and epiphysiodesis, with some patients also having open lumbar exposure and posterior fusion.
- Data collected included surgical times, extubation, intensive care unit (ICU) stay, and chest tube duration.
Main Results:
- All thoracoscopic procedures were completed successfully, with average surgical times comparable to open techniques.
- The majority of patients were extubated on postoperative day 1, with an average ICU stay of 1.8 days.
- Surgical correction was deemed acceptable and equivalent to open techniques, with earlier extubation and chest tube removal observed.
Conclusions:
- Thoracoscopic anterior spinal surgery is a safe and effective technique for pediatric patients with spinal deformities.
- This minimally invasive approach appears to reduce pain and morbidity, indicated by shorter ICU stays and earlier removal of chest tubes.
- The findings support the use of thoracoscopic techniques as a viable alternative to open surgery in this population.