A new study published in Clinical Spine Surgery examines minimally invasive spinal surgery techniques for adolescent idiopathic scoliosis patients compared to the standard open posterior approach.
The researchers examined seven patients in the minimally invasive group and 15 in the open posterior approach group. The patients were followed for at least two years. The minimally invasive approaches have been used successfully in adults to correct multilevel spine pathology.
The perioperative characteristics of the patients were similar in both groups. The researchers found:
1. The patients in the MIS group had fewer fixation points.
2. The MIS patients had longer operative times than the open group on average.
3. There wasn't a significant difference in blood loss, estimated blood loss/fixation point and amount of fluid administered between the two groups.
4. Both groups reported the same number of days in the intensive care units and spent a similar amount of time recovering from the procedure. Additional factors that were similar for both groups include:
- Length of stay in the hospital
- Time to mobilization
- Visual analogue scale pain
- Patient-controlled analgesia
5. The patients in the minimally invasive group had similar deformity correction, fusion status and screw placement accuracy as the open group.
6. The MIS patients reported shorter fusions, fewer pedicle screws and lower blood transfusion rate than the open group.
"The short term advantages seen in MIS for adult scoliosis were not as obvious in our series," concluded the study authors. "We found similar deformity correction and adequate fusion, however shortcomings related to learning curve, and instrumentation persist. MIS surgery is an innovative treatment for AIS that is technically feasible with significantly lower transfusion rate, shorter fusion lengths and lesser pedicle screw fixation."