THORACOSCOPIC DISCECTOMY IN SURGICAL TREATMENT OF CHILDREN WITH IDIOPATHIC SCOLIOSIS

Objective. To analyze specific features of thoracoscopic discectomy and results of its application in children with thoracic idiopathic scoliosis.

Material and Methods. A total of 42 patients (33 females and 9 males) aged 13 to 18 years who had right-sided thoracic idiopathic scoliosis were operated on. All patients underwent one stage endoscopic discectomy with corporodesis through anterolateral approach, and posterior correction of the deformity with multiple-anchor instrumentation accompanied by intraoperative halo-tibial traction and followed by posterior local fusion. The follow-up period ranged from 6 months to 3 years.

Results. Postoperative Cobb angle of residual scoliotic deformity was 10–20° as reported by X-ray study. Deformity correction was 79.9 ± 6.5 %. Patients were verticalized on the 3–6th days and discharged on the 8–10th days after surgery to outpatient treatment. The improvement or complete restoration of the trunk balance was achieved. The pain syndrome intensity was 6–7 scores.

Conclusion. Indications for thoracoscopic discectomy are rigid curves less than 90 degrees and unfinished growth in a child. Application of endoscopic discectomy at the anterior stage of surgical intervention in patients with idiopathic scoliosis provided insignificant blood loss during discectomy, decreased intensity of postoperative pain syndrome, and improved cosmetic outcome after the surgery.

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