Thoracoscopic-assisted anterior release of the spine

Abstract

This paper describes our experience and the technical difficulties in thoracoscopic-assisted anterior release of the thoracic spine. It is illustrated by 2 cases of thoracic scoliosis which were operated on by a staged thoracoscopic-assisted anterior release and posterior spinal fusion with a mean follow-up of 13.5 months. In both cases the spine could be released adequately and uneventfully. Postoperative morbidity was minimal. Such patients do not require postoperative halo traction but are able to lie directly on the wound and hence the convexity of the curve to improve its flexibility. We have found thoracoscopic-assisted anterior release of the spine to be a promising new technique. It has the theoretical advantage of allowing one stage anterior and posterior surgery while minimising surgical trauma and reducing postoperative morbidity. We make recommendations on operating room set-up and surgical technique.