Comparative Analysis of Radiologic and Clinical Outcomes Between Conventional Open and Minimally Invasive Scoliosis Surgery for Adolescent Idiopathic Scoliosis

Abstract

To compare radiologic and clinical outcomes between conventional open scoliosis surgery (COSS) and minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS). Forty-nine AIS patients who underwent scoliosis surgery were retrospectively analyzed in 2 groups: the COSS (n= 25) and MISS (n= 24) groups. COSS procedures used monoaxial screws with a rod derotation (RD) maneuver through a long linear incision. In the MISS group, the technique was applied via 2 or 3 incisions of about 3 cm in length, and a muscle-splitting approach and correction were performed using polyaxial screws with an RD maneuver. In the analysis of the coronal (Cobb angle of the main curve) and sagittal planes (thoracic kyphosis and lumbar lordosis), correction was significantly superior in the COSS group (all P values >0.05). However, in the coronal balance and spinal vertical axis, which are global balance factors, there were no significant differences between the groups (P= 0.331 and P= 0.750). There were significant differences between the COSS and MISS groups in terms of mean hospital stay duration (P < 0.001), operative time (P < 0.001), estimated blood loss (P < 0.001), and scar length (P < 0.001). There was no significant difference in the various Scoliosis Research Society-22 questionnaire scores between the groups. Although COSS for AIS was superior for correcting the main curve, MISS was associated with shorter hospitalization, less blood loss, and superior cosmesis as well as providing adequate correction in both the coronal and sagittal planes.