A comparative study of clinical efficacy of thoracoscopic surgery, traditional open chest anterior approach and posterior approach on adolescent idiopathic scoliosis

摘要

abstract_textpObjective: To evaluate the clinical efficacy of three surgical methods: thoracoscopic surgery, traditional open chest anterior approach and posterior approach on scoliosis correction. Methods: A total of 60 adolescent scoliosis cases with surgical treatment from January 2010 to June 2016 were retrospectively analyzed. According to their operation methods, they were divided into three groups: thoracoscopy group (T group), open chest group (OC group) and posterior group (P group) with 20 cases in each group. The perioperative parameters (operating time (min), intraoperative blood loss (mL), the lengths of hospital stay (d), postoperative 24 h Visual Analogue Scale (VAS) pain scores), postoperative upper extremities functional scores, corrective efficacy of scoliosis and the complications of patients were recorded. The excellent rates of symptoms reduction and the condition of the interbody fusion were observed in the follow-up period. Results: The blood losses in T group (250+/-35.2 mL) were less than those in OC group (365+/-40.5 mL) and those in P group (360+/-51.2 mL) (all P0.001). And the VAS pain scores were lower in T group as well (all P0.001). Although the operating time was longer in T group, the lengths of hospitalization were significantly decreased (all P0.001). The postoperative upper extremities functional scores were higher in T group than in OC group and in P group (all P0.001). The postoperative excellent and good rates of symptoms reduction in T group, OC group and P group were 75.7, 80.0 and 78.6 respectively (P=0.676). All the cases showed good osseointegration. The average correction rates of scoliosis Cobb angle in T group, OC group and P group were 55.05, 59.87 and 60.55 respectively (P=0.972). Conclusion: Good surgical efficacy can be achieved by thoracoscopy, traditional open chest anterior approach and posterior approach. Meanwhile, thoracoscopic surgery has obvious advantages in the reduction of intraoperative blood loss, pain, upper extremities disorders and so on./p/abstract_text