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Erschienen in:
27.07.2020 | Original Article
Minimally invasive surgery versus standard posterior approach for Lenke Type 1–4 adolescent idiopathic scoliosis: a multicenter, retrospective study
Erschienen in: European Spine Journal | Ausgabe 3/2021
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Purpose
To compare the safety and efficacy of posterior minimally invasive surgery (MIS) to standard posterior spinal fusion (PSF) surgery for Lenke Type 1–4 adolescent idiopathic scoliosis (AIS).
Methods
This multicenter retrospective study enrolled 112 patients with Lenke Type 1–4 AIS who treated with MIS (n = 64) or PSF (n = 48) between March 2007 and January 2015. Coronal and sagittal parameters were evaluated before surgery, immediately after surgery, and at the last follow-up. Operative time, level of fusion, intraoperative blood loss, blood transfusion, and intraoperative radiation exposure were recorded. 22-item Scoliosis Research Society questionnaire (SRS-22) was applied for assessment of life quality. The accuracy of pedicle screw placement was assessed according to postoperative computed tomography images, and the complications were collected in follow-up period.
Results
The baseline characteristics of 2 groups were matched. There was no significant difference between 2 groups in terms of radiographic parameters immediately after surgery and at the last follow-up. The MIS group had significantly longer operative time, more level of fusion, less intraoperative blood loss, and lower blood transfusion rate (p < 0.001). The evaluation of pain using SRS-22 showed significantly lower score in MIS group (p < 0.05). No significant difference was found between 2 groups in terms of accuracy of pedicle screw placement and complications.
Conclusion
Posterior MIS is a safe and effective alternative to standard open approach for Lenke Type 1–4 AIS patients with curves < 70° and reasonable flexibility. Mid-term results showed MIS had the advantages of less blood loss and pain with more fusion segments.