[Long term outcome of video-assisted thoracoscopic surgery for thoracic adolescent idiopathic scoliosis].

OBJECTIVE

To study the long term outcomes and complications of video-assisted thoracoscopic surgery (VATS) in correcting thoracic adolescent idiopathic scoliosis (T-AIS) with more than five-year follow-up.

METHODS

The T-AIS patients underwent corrective surgery by VATS between June 2002 and December 2006 and experienced more than five-year follow-up were retrospectively reviewed. Nine female patients with T-AIS were recruited with a mean age of 14.3 years (range 11 - 16 years) at operation. Radiological parameters including thoracic and lumbar curves, thoracic kyphosis (T(5)-T(12)), sagittal alignment of the thoracolumbar junction (T(10)-L(2)) and lumbar lordosis (T(12)-S(1)) were measured on the X-rays taken preoperatively, 3 months, 2 year postoperatively and at latest follow-up. Complications occurred after operation and during follow-up were retrieved. The Chinese edition SRS-22 was finished by patients at the latest follow-up. Repeated-measures analysis of variance and paired t test were used for statistical analysis.

RESULTS

The patients were followed for a mean of 6.2 years (5 - 7.5 years) after VATS. The mean thoracic curve was corrected from 51° ± 8° preoperatively to 20° ± 8° at 3 months post-operation, and 21° ± 12° and 25° ± 13° at 2 year post-operation and latest follow-up, respectively. During the follow-up, no significant changes were observed regarding to coronal and sagittal radiological parameters (P > 0.05). Rod breakage occurred in 1 patient and Adding on was found in another one patient 2 year post-operation. Revision surgery was not needed for the solid fusion achieved and lack of correction loss. The mean score of SRS-22 at final follow-up was 4.3 ± 0.3, with high score in most of the domains.

CONCLUSIONS

Loss of curve correction and implant-related complication are found in VATS-treated T-AIS patients at the long-term follow-up. Although the patients show high scores in SRS-22, which indicated higher functional outcome and satisfaction to the operation, special care should be taken for applying VATS to T-AIS patients for the concern of long-term complication.