LAUSR

OBJECTIVE To compare radiological and clinical outcomes between conventional open scoliosis surgery (COSS) and minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS). METHODS Forty-nine AIS patients who underwent scoliosis surgery were retrospectively analyzed in two groups: the COSS (n=25) and MISS (n=24) groups. COSS procedures used mono-axial screws with a rod derotation (RD) maneuver through a long linear incision. In the MISS group, the technique was applied via two or three incisions of about 3 cm in length, and a muscle-splitting approach and correction were performed using poly-axial screws with an RD maneuver. RESULTS In the analysis of the coronal (Cobb's angle of the main curve) and sagittal planes (thoracic kyphosis and lumbar lordosis), correction was significantly superior in the COSS group (all P values > 0.05). However, in the coronal balance and spinal vertical axis, which are global balance factors, there were no significant differences between the groups (P = 0.331 and P = 0.750). There were significant differences between the COSS and MISS groups in terms of mean hospital stay duration (P < 0.001), operative time (P < 0.001), estimated blood loss (P < 0.001), and scar length (P < 0.001). There was no significant difference in the various SRS-22 questionnaire scores between the groups. CONCLUSIONS Although COSS for AIS was superior for correcting the main curve, MISS was associated with shorter hospitalization, less blood loss, and superior cosmesis as well as providing adequate correction in both the coronal and sagittal planes.