Baron S. Lonner, MD
The goals of scoliosis management are well recognized and include prevention of progression, maintenance of respiratory function with preservation of neurologic status and cosmesis. The advent of Harrington instrumentation in the late 50's and the subsequent improvement in instrumentation by Dwyer, Zielke, Cotrel and Dubousset, have led to marked improvement in the ability to deal with the complex problems of scoliosis management.
The anterior spinal approach has the advantage of improved mobilization of the spine, fusion of fewer segments and excision of the growth plates in young patients that may prevent the crankshaft phenomenon. As more surgeons gained experience with the anterior approach, it led to the development of a less invasive means of treatment with the goal of obtaining similar results. Video assisted thoracoscopic surgery has provided the spine surgeon with an endoscopic option in anteriorly approaching the thoracic and thoracolumbar spine. The endoscopic approach incorporates all the benefits of the open procedure. In addition, there is improved visualization of the spine, with enhanced access to the disc spaces especially at the ends of the curve, without the associated risks and poor cosmetic result from a thoracotomy incision. This allows for expedited patient rehabilitation and earlier discharge from the hospital with a greatly improved cosmetic result.
In this JBJS/VJO video supplement to the article "Anterior Thoracoscopic Spinal Fusion for Thoracic Adolescent Idiopathic Scoliosis", Baron S. Lonner, MD of Lenox Hill Hospital, New York demonstrates his surgical technique and provides pearls in avoiding complications.
Click on any of the images below for a larger view:
See the Corresponding JBJS Article:
- Baron S. Lonner, MD, Dimitry Kondrachov, MD, Farhan Siddiqi, MD, Victor Hayes, MD and Carrie Scharf, BA
- Thoracoscopic Spinal Fusion Compared with Posterior Spinal Fusion for the Treatment of Thoracic Adolescent Idiopathic Scoliosis.
Bone Joint Surg. Am., May 2006; 88: 1022 – 1034. [Article]
- Baron S. Lonner, Dimitry Kondrachov, Farhan Siddiqi, Victor Hayes, and Carrie Scharf
- Thoracoscopic Spinal Fusion Compared with Posterior Spinal Fusion for the Treatment of Thoracic Adolescent Idiopathic Scoliosis: Surgical Technique
J. Bone Joint Surg. Am., Mar 2007; 89: 142 – 156. [Article]
- Total Run Time: 34:54 minutes
- Catalog Number: 8019
- VJO Publication Date: March, 2007