OBJECTIVE: to describe the initial results of anterior videothoracoscopic release followed by posterior instrumentation for surgical correction of adolescent idiopathic scoliosis. METHODS: twenty patients were selected, between August 1989 and May 2001, with stiff, King III, right thoracic adolescent idiopathic scoliosis. They underwent anterior videothoracoscopic release followed by posterior correction and fixation with Hartshill instrumentation, performed in a single surgical stage. RESULTS: all procedures were successfully completed with videothoracoscopy, without need to convert to thoracotomy. The average age was 15.7 years (12 to 21 years). Concerning the length of hospital stay, there was a mean of 9.45 days (5 to 26 days). The preoperative Cobb angle average was 66.25º (48º to 92º), and the mean postoperative Cobb angle was 31.2º (15º to 45º). As complications, there were four patients with intercostal neuralgia (20%) and one with atelectasis (5%). CONCLUSIONS: the videothoracoscopic discectomy is a safe and effective method for making flexible the rigid scoliotic curves. However, this is a technically demanding procedure that requires prolonged and exhaustive training, with a steep learning curve.
Scoliosis; Thoracoscopy; Thoracic surgery, video-assisted; Intervertebral disk; Thoracotomy
