Minimally invasive surgery for adolescent idiopathic scoliosis: correction of deformity and peri-operative morbidity in 70 consecutive patients.

Détails

ID Serval
serval:BIB_9E807D94AC88
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Minimally invasive surgery for adolescent idiopathic scoliosis: correction of deformity and peri-operative morbidity in 70 consecutive patients.
Périodique
The bone & joint journal
Auteur(s)
de Bodman C., Miyanji F., Borner B., Zambelli P.Y., Racloz G., Dayer R.
ISSN
2049-4408 (Electronic)
ISSN-L
2049-4394
Statut éditorial
Publié
Date de publication
12/2017
Peer-reviewed
Oui
Volume
99-B
Numéro
12
Pages
1651-1657
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
The aim of this study was to report a retrospective, consecutive series of patients with adolescent idiopathic scoliosis (AIS) who were treated with posterior minimally invasive surgery (MIS) with a mean follow-up of two years (sd 1.4; 0.9 to 0 3.7). Our objectives were to measure the correction of the deformity and record the peri-operative morbidity. Special attention was paid to the operating time (ORT), estimated blood loss (EBL), length of stay (LOS) and further complications.
We prospectively collected the data of 70 consecutive patients with AIS treated with MIS using three incisions and a muscle-splitting approach by a single surgeon between June 2013 and February 2016 and these were retrospectively reviewed. There were eight male and 62 female patients with a mean age of 15 years (sd 4.5 ) with a mean body mass index of 19.8 kg/m2 (sd 5.4). The curves were classified according to Lenke; 40 curves were type 1, 15 were type 2, three were type 3, two were type 4, eight were type 5 and two were type 6.
The mean primary Cobb angle was corrected from 58.9° (sd 12.6°) pre-operatively to 17.7° (sd 10.2°) post-operatively with a mean correction of 69% (sd 20%, p < 0.001). The mean kyphosis at T5 to T12 increased from 24.2° (sd 12.2°) pre-operatively to 30.1° (sd 9.6°, p < 0.001) post-operatively. Peri-operative (30 days) complications occurred in three patients(4.2%): one subcutaneous haematoma, one deep venous thrombosis and one pulmonary complication. Five additional complications occurred in five patients (7.1%): one superficial wound infection, one suture granuloma and three delayed deep surgical site infections. The mean ORT was 337.1 mins (sd 121.3); the mean EBL was 345.7 ml (sd 175.1) and the mean LOS was 4.6 days (sd 0.8).
The use of MIS for patients with AIS results in a significant correction of spinal deformity in both the frontal and sagittal planes, with a low EBL and a short LOS. The rate of peri-operative complications compares well with that following a routine open technique. The longer term safety and benefit of MIS in these patients needs to be evaluated with further follow-up of a larger cohort of patients. Cite this article: Bone Joint J 2017;99-B:1651-7.

Mots-clé
Adolescent, Blood Loss, Surgical, Child, Female, Humans, Length of Stay, Male, Minimally Invasive Surgical Procedures/adverse effects, Minimally Invasive Surgical Procedures/methods, Morbidity, Perioperative Period, Retrospective Studies, Scoliosis/diagnostic imaging, Scoliosis/surgery, Spinal Fusion/adverse effects, Spinal Fusion/methods, Treatment Outcome, Young Adult, Adolescent idiopathic scoliosis, Correction of deformity, Minimally invasive surgery, Peri-operative morbidity
Pubmed
Web of science
Création de la notice
14/12/2017 18:36
Dernière modification de la notice
20/08/2019 15:04
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