PDF(Pubmed)
Abstract：
Background: Minimally invasive surgical (MIS) techniques have gained popularity as a safe and effective alternative to open surgery for degenerative, traumatic, and metastatic spinal pathologies. In adolescent idiopathic scoliosis, MIS techniques comprise anterior thoracoscopic surgery (ATS), posterior minimally invasive surgery (PMIS), and vertebral body tethering (VBT). In the current systematic review, the authors collected and analyzed data from the available literature on MIS techniques in AIS. Methods: The articles were shortlisted after a thorough electronic and manual database search through PubMed, EMBASE, and Google Scholar. Results: The authors included 43 studies for the review; 14 described the outcomes with ATS, 13 with PMIS, and 16 with VBT. Conclusions: While the efficacy of the ATS approach is well-established in terms of comparable coronal and sagittal correction to posterior spinal fusion, the current use of ATS for instrumented fusion has become less popular due to a steep learning curve, high pulmonary and vascular complication rates, implant failures, and increased non-union rates. PMIS is an effective alternative to the standard open posterior spinal fusion, with a steep learning curve and longer surgical time being potential disadvantages. The current evidence, albeit limited, suggests that VBT is an attractive procedure that merits consideration in terms of radiological correction and clinical outcomes, but it has a high complication and re-operation rate, while the most appropriate indications and long-term outcomes of this technique remain unclear.
摘要：
背景：微创手术（MIS）技术已成为一种安全有效的退行性开放手术替代方法，创伤性,和转移性脊柱病变。在青少年特发性脊柱侧弯中，MIS技术包括前路胸腔镜手术（ATS），后路微创手术（PMIS），和椎体束缚（VBT）。在当前的系统审查中，作者收集并分析了现有文献中有关AIS中MIS技术的数据。方法：通过PubMed进行全面的电子和手动数据库搜索后，将文章入围，EMBASE,谷歌学者。结果：作者纳入了43项研究的综述；14项描述了ATS的结果，13与PMIS，和16与VBT。结论：虽然ATS方法的疗效在冠状和矢状矫正方面与后路脊柱融合术相当，由于学习曲线陡峭，目前使用ATS进行仪器融合已变得不那么受欢迎，高的肺和血管并发症发生率，植入失败,和增加不工会率。PMIS是标准的开放式后路脊柱融合术的有效替代方案，陡峭的学习曲线和较长的手术时间是潜在的缺点。目前的证据,虽然有限，表明VBT是一个有吸引力的程序，值得考虑的放射学校正和临床结果，但并发症和再手术率高,而这项技术的最合适的适应症和长期结局仍不清楚。
