Journal of pediatric surgery · 2026
Revisiting the mini open thoracoscopically-assisted anterior (MOTA) approach for thoracic and thoracolumbar spine exposure in adolescent idiopathic scoliosis: A single institution experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Youssef George, Mucollari Olgerta, Wu Jeanne, Lonner Baron, Dolgopolov Sergei
Аннотация
INTRODUCTION: Surgical correction of adolescent idiopathic scoliosis (AIS) has traditionally relied on posterior spinal fusion (PSF). However anterior vertebral body tethering (VBT) has offered a motion-preserving alternative that maintains spinal flexibility. This study describes our institutions' mini-open thoracoscopically assisted anterior (MOTA) approach and outcomes for anterior spinal VBT exposure.
METHODS: 344 patients with AIS treated with anterior VBT between February 2016 and July 2024 were reviewed. Operative data included type of approach, instrumented spinal levels, rib resection, operative time, and EBL. Outcomes data included LOS, chest tube duration, foley, epidural placement, and 30-day complications. Data was analyzed using ANOVA, chi-squared, and Tukey Honestly Significant Difference. Aggregate results were compared with literature outcomes of VBT and PSF.
RESULTS: Double curve cases were found to have longer operative times, increased EBL, longer LOS, and longer duration of epidural and foley compared to other approaches but also had the greatest number of instrumented spinal levels. In aggregate, we found our MOTA approaches to have significantly shorter operative times (182.54 min) than literature VBT (327.93) while still having comparable EBL (155.8 cc), length of stay (5.42 days) and postoperative opioid use (3.4 days) when compared with literature VBT outcomes.
DISCUSSION: Our institution has found success in the management of AIS with MOTA thoracic and thoracolumbar spinal exposures. We caution that providers must have thorough understanding of the surgical anatomy and dissection technique prior to offering this correction approach.
METHODS: 344 patients with AIS treated with anterior VBT between February 2016 and July 2024 were reviewed. Operative data included type of approach, instrumented spinal levels, rib resection, operative time, and EBL. Outcomes data included LOS, chest tube duration, foley, epidural placement, and 30-day complications. Data was analyzed using ANOVA, chi-squared, and Tukey Honestly Significant Difference. Aggregate results were compared with literature outcomes of VBT and PSF.
RESULTS: Double curve cases were found to have longer operative times, increased EBL, longer LOS, and longer duration of epidural and foley compared to other approaches but also had the greatest number of instrumented spinal levels. In aggregate, we found our MOTA approaches to have significantly shorter operative times (182.54 min) than literature VBT (327.93) while still having comparable EBL (155.8 cc), length of stay (5.42 days) and postoperative opioid use (3.4 days) when compared with literature VBT outcomes.
DISCUSSION: Our institution has found success in the management of AIS with MOTA thoracic and thoracolumbar spinal exposures. We caution that providers must have thorough understanding of the surgical anatomy and dissection technique prior to offering this correction approach.