Mimics software used for individualized preoperative design of chest portals in thoracoscopic anterior release for thoracic scoliosis

Abstract

Objective To investigate the feasibility and advantage of using Mimics software to individually design chest portals preoperatively in thoracoscopic anterior release for patients with thoracic scoliosis.Methods This series consisted of 3 males and 6 females,with an average age of 14.7 years (ranging from 12 to 18 years).By Lenke classification,there were 3 cases of type Ⅰ and 6 rases of type Ⅱ.Their preoperative main thoracic Cobb angles at the coronal plane ranged from 85° to 110°( average,96°)、and their average flexibility was 25.3％ (from 15％ to 29％ ).Before operation,CT data of the patients ( including spine and thorax) were imported into the Mimies software to complete design for chest portals (ineluding the number and site) for each individual patient.The individually designed chest portals were used in clinic anterior spinal release to correct the stiff curve.Posterior correction,internal fixation,bone graft and fusion were carried out in the secondary surgery for the scoliosis. Reslts All the 9 cases completed anterior spinal release under thoracoscopy.Five intervertebral spaces were released in 6 rases,and 6 in 3.Four partals were designed for 5 patients and 3 portals for the rest 4 cases.The operative time ranged from 85 to 150 minutes (average,113 minutes),and blood loss ranged from 200 to 400 mL(average,275 mL) during the operation.No respiratory failure,death or other serions complications occurred after the operation.The last correction rates after 2 operations ranged from 52％ to 69％ (average,57.6％ ).Appearances of the patients were greatly improved.The positions of individually designed 32 portals for the 9 patients were 1 to 7 cm (average,3.5 cm) more backward than those conventionally designed. Conclusions Mimics software can be used to individually design preoperative chest portals in thoracoscopic anterior release for patients with thoracic scoliosis.The individual design can be completed in computer and thus provide ideal positions to facilitate the opetation. Key words: Software; Thoracoscopy; Scoliosis