Minimally invasive ventral release and endoscopic ventral instrumentation in scoliosis

Abstract

We report on three years of experience with a new method of a simultaneous endoscopically assisted anterior release in the prone position, combined with transpedicular posterior scoliosis correction and fixation. In 60 cases this simultaneous approach yielded substantial advantages. True derotation of the apex--even in the thoracic spine--is achieved. Because of resection of apical discs, the hypokyphosis can be corrected easily. Apical derotation, restoration of the kypotic profile and more effective correction of lateral translation add up to true three-dimensional correction of scoliosis. The disadvantages of insufficient anterior anchorage of fixation implants are avoided, since correction and fixation are achieved posteriorly. An additional advantage of this combined approach and the use of pedicular screws is the fact that in idiopathic scoliosis fusion that is no longer than from end- to end-vertebrae is sufficient. Thus, in most King II curves the thoracolumbar junction does not need to be fused.