• Chong Suh Lee, Se Jun Park, Sung Soo Chung, Kyung Chung Kang, Chul Hee Jung, and Yang Tae Kim.
• Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
• J Spinal Disord Tech. 2013 Aug 1; 26 (6): 325-33.

Study DesignA retrospective comparative study.ObjectiveTo present the results of thoracoscopic surgery in the treatment of adolescent idiopathic scoliosis (AIS) and to compare the results of thoracoscopic surgery with those of posterior surgery.Summary Of Background DataAlthough racoscopic scoliosis correction has attracted attention since the early 2000s, its use has declined gradually, whereas posterior surgery using pedicle screws has become popular. Few studies have compared thoracoscopic surgery with posterior pedicle screw fixation for single thoracic AIS correction.MethodsSixty-five patients with Lenke type-1 AIS were included and followed up for a minimum of 24 months. Forty-two patients underwent thoracoscopic surgery (thoracoscopic group) and 23 patients underwent posterior surgery (posterior group). Radiographic outcomes, including the correction rate and loss of correction, perioperative morbidities, and complications, were compared.ResultsBoth groups were similar in terms of the preoperative baseline data. Although the correction rate of major thoracic curve was similar, the posterior group had a tendency to have a greater correction rate (72% vs. 66%). A loss of correction was significantly greater in the thoracoscopic group. The thoracoscopic group had a longer operation time and less intraoperative blood loss, with a lower transfusion rate than the posterior group. There was no difference at the last follow-up in terms of pain score and satisfaction. Five implant failures (12%) occurred in the thoracoscopic group and none in the posterior group. There were 3 patients with significant pulmonary complications necessitating active treatments in the thoracoscopic group.ConclusionsDespite its advantages, thoracoscopic surgery is losing its place in the surgical correction of AIS because of the frequent perioperative pulmonary complications and fixation problems compared with posterior pedicle screw fixation. Nevertheless, it can be utilized in selected cases particularly in cases of patient's strong demand for minimally invasive surgery.

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