Minimally Invasive Scoliosis Surgery Is a Feasible Option for Management of Idiopathic Scoliosis and Has Equivalent Outcomes to Open Surgery: A Meta-Analysis

Abduljabbar Alhammoud, Yahya Alborno, Abdul Moeen Baco, Yahya Azhar Othman, Yoji Ogura, Michael Steinhaus, Evan D Sheha, Sheeraz A Qureshi, Abduljabbar Alhammoud, Yahya Alborno, Abdul Moeen Baco, Yahya Azhar Othman, Yoji Ogura, Michael Steinhaus, Evan D Sheha, Sheeraz A Qureshi

Abstract

Study design: Meta-analysis.

Objective: To compare outcomes between minimally invasive scoliosis surgery (MISS) and traditional posterior instrumentation and fusion in the correction of adolescent idiopathic scoliosis (AIS).

Methods: A literature search was performed using MEDLINE, PubMed, EMBASE, Google scholar and Cochrane databases, including studies reporting outcomes for both MISS and open correction of AIS. Study details, demographics, and outcomes, including curve correction, estimated blood loss (EBL), operative time, postoperative pain, length of stay (LOS), and complications, were collected and analyzed.

Results: A total of 4 studies met the selection criteria and were included in the analysis, totaling 107 patients (42 MIS and 65 open) with a mean age of 16 years. Overall there was no difference in curve correction between MISS (73.2%) and open (76.7%) cohorts. EBL was significantly lower in the MISS (271 ml) compared to the open (527 ml) group, but operative time was significantly longer (380 min for MISS versus 302 min for open). There were no significant differences between the approaches in pain, LOS, complications, or reoperations.

Conclusion: MISS was associated with less blood loss but longer operative times compared to traditional open fusion for AIS. There was no difference in curve correction, postoperative pain, LOS, or complications/reoperations. While MISS has emerged as a feasible option for the surgical management of AIS, further research is warranted to compare these 2 approaches.

Keywords: adolescent idiopathic scoliosis; idiopathic scoliosis; minimally invasive scoliosis surgery; minimally invasive surgery; open surgery; posterior fusion; spinal fusion.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Qureshi reports other from Cervical Spine Research Society, personal fees from Stryker K2M, other from Simplify Medical, Inc., other from Avaz Surgical, other from International Society for the Advancement of Spine Surgery, other from North American Spine Society, other from LifeLink.com Inc., other from Association of Bone and Joint Surgeons, other from Society of Lateral Access Surgery, personal fees from Globus Medical, Inc., personal fees from Paradigm Spine, other from Society of Minimally Invasive Spine Surgery, other from Minimally Invasive Spine Study Group, personal fees from RTI Surgical Inc., other from Spinal Simplicity, LLC, personal fees from AMOpportunities, other from Contemporary Spine Surgery, other from Annals of Translational Medicine, personal fees from Healthgrades, other from The American Orthopaedic Association, other from Vital 5, outside the submitted work

Figures

Figure 1.
Figure 1.
PRISMA 2009 flow diagram.
Figure 2.
Figure 2.
Curve correction. (a) Overall; (b) Lenke 5; (c) Lenke 1-4.
Figure 3.
Figure 3.
Estimated blood loss. (a) Overall; (b) Lenke 5; (c) Lenke 1-4.
Figure 4.
Figure 4.
Operation time. (a) Overall; (b) Lenke 5; (c) Lenke 1-4.
Figure 5.
Figure 5.
Pain score.
Figure 6.
Figure 6.
Hospital stay.
Figure 7.
Figure 7.
Overall complication (a) and reoperation rate (b).

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