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Adolescent Scoliosis

  • Daniel J. Miller
  • Todd J. Blumberg
  • Susan E. Nelson
  • Per D. Trobisch
  • Patrick J. CahillEmail author
Chapter

Abstract

Traditionally, scoliosis surgery has been associated with morbidity of large wounds, lengthy surgeries, and significant blood loss. Typical surgery for adolescent scoliosis involves wide exposure of bony anatomy to facilitate multi-segmental instrumentation and fusion, a fact that makes application of minimally invasive surgery (MIS) principles more challenging.

Although more common in adult spine surgery, MIS or less invasive surgery (LIS) techniques and principles are being applied to pediatric spinal deformity as well. Less invasive methods of performing traditional open anterior and posterior spinal fusions have been described. Thoracoscopic anterior spinal fusion allows for minimally invasive instrumentation and fusion and is associated with decrease surgical blood loss and quicker recovery compared to open spinal fusion. We also discuss our less invasive technique for posterior spinal fusion that includes transmuscular insertion of pedicle screws and rods with preservation of the midline attachments of the paraspinal muscles.

Several surgeons are also adapting the MIS principles of preservation of structural anatomy and motion in innovative ways, including vertebral body stapling and vertebral body tethering. We discuss our techniques for vertebral body stapling and tethering and present the available literature on outcomes and complications of these growth modulation techniques for idiopathic scoliosis.

Keywords

Adolescent scoliosis Thoracoscopic surgery Growth modulation Vertebral stapling Vertebral tethering 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Daniel J. Miller
    • 1
  • Todd J. Blumberg
    • 2
  • Susan E. Nelson
    • 3
  • Per D. Trobisch
    • 4
  • Patrick J. Cahill
    • 5
    Email author
  1. 1.Department of Orthopaedic SurgeryGillette Children’s Specialty HealthcareSt. PaulUSA
  2. 2.Department of Orthopaedics and Sports MedicineUniversity of Washington/Seattle Children’s HospitalSeattleUSA
  3. 3.Department of Orthopaedic SurgeryChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  4. 4.Department of Spinal SurgeryEifelklinik St. BrigidaSimmerathGermany
  5. 5.Division of Orthopaedic SurgeryThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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