The efficacy of video-assisted thoracoscopic surgery for anterior release and fusion in the management of pediatric spinal deformities

Purpose: This study examined clinical and radiological outcomes following video-assisted thoracoscopic surgery (VATS) for anterior release and fusion in the correction of pediatric scoliotic deformities. Methods: We undertook a detailed chart and radiographic review to determine the degree of correction and perioperative morbidity and complications, if any, of a sequential group of patients who underwent VATS between 2000 and 2004 at British Columbia's Children's Hospital. We used patients who underwent open thoracotomy immediately before the adoption of the VATS technique at the same hospital to evaluate the relative efficacy of VATS. Results: There were 19 patients in each group, 17 with idiopathic scoliosis in the VATS group and 16 in the open thoracotomy group. Mean age, weight at surgery and preoperative Cobb angle were similar (p = 1.0, 0.8 and 0.05, respectively). There was no significant difference in operative time per level between the VATS group and the open thoracotomy group (37.2 v. 34.5 min, p = 0.2) or total blood loss (908 v. 823 mL, p = 0.5). There were no major complications encountered in the VATS group. One patient in the open thoracotomy group experienced atelectasis and subsequent lower lobe collapse. Conclusions: VATS has the potential to decrease postoperative morbidity while still allowing the same degree of correction as traditional open thoracotomies and is a good alternative in the pediatric population.