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Vẹo cột sống tự phát

Thoracoscopically hỗ trợ phẫu thuật IS một cách tiếp cận mới để truy cập vào cột sống phía trước để Thực hiện sinh thiết, thông cáo trước, diskectomies, và thiết bị đo đạc trước và phản ứng tổng hợp đối với chứng vẹo cột sống ngực vô căn. Cách tiếp cận này làm suy yếu thành ngực | Perspectives on Modern Orthopaedics Thoracoscopic Anterior Instrumentation and Fusion for Idiopathic Scoliosis Daniel J. Sucato MD MS Abstract Thoracoscopically assisted surgery is a new approach to access the anterior spine to perform biopsies anterior releases diskectomies and anterior instrumentation and fusion for idiopathic thoracic scoliosis. This approach compromises the chest wall less than an open thoracotomy does because it uses several small portal incisions. It has been suggested that this approach allows fusion of fewer motion segments and better correction of curvature than does posterior spinal fusion and instrumentation. The technique which is still evolving is technically demanding requiring advanced training and special instrumentation and anesthesia techniques. J Am Acad Orthop Surg 2003 11 221-227 Surgical treatment for idiopathic scoliosis has changed rapidly in the last 20 years. Posterior segmental spinal instrumentation was an advance over Harrington instrumentation because it improved correction in the sagittal and coronal planes.1 2 The single solid rod used with anterior surgery was an improvement over the Dwyer cable especially for thoracolumbar and lumbar curves because it allowed surgeons to use a rotational maneuver to correct both the sagittal and coronal deformities.1 2 Recently the single solid rod placed through an open thoracotomy has been used to correct thoracic curves.3 4 Anterior correction of thoracic scoliosis offers the theoretic advantage of better coronal correction because it permits the surgeon to perform diskectomies provides improvement in the thoracic hypokyphosis seen in idiopathic scoliosis and saves motion segments. In a prospective study Betz et al4 demonstrated that anterior surgery improved sagittal plane alignment while saving an average of 2.5 distal motion segments compared with posterior surgery. In the last decade indications have increased for endoscopic approaches to thoracic spine surgery. Endoscopy .