Minimally invasive surgery in the treatment of adolescent idiopathic scoliosis: A literature review and meta-analysis

Background contextSpinal fusion surgery for scoliosis can be performed using a traditional open approach, or by following a minimally invasive approach. Minimally invasive surgery (MIS) is associated with theoretical advantages, such as reduced blood loss and a shorter hospital stay, yet there is no consensus in the literature with regard to the best treatment approach for adolescent idiopathic scoliosis (AIS).PurposeTo assess the clinical outcomes of patients with AIS treated with either an open or minimally invasive approach.Study designSystematic review and meta-analysis of English-language studies for the treatment of adolescent idiopathic scoliosis.Patient samplePooled results from level 1 and 2 studies.MethodsWe carried out a systematic literature search of EMBASE and MEDLINE, identifying studies investigating MIS in the treatment of AIS. Percentages of curvature correction were pooled and analysed.ResultsThe literature search returned 50 articles, of which we determined 4 studies to be relevant. The pooled percentage curve correction across these groups was 62.05% for the MIS group and 70% for the open surgery group. Although these data are significant (p = 0.001), the available studies are of variable quality, and sample sizes small.ConclusionsPatients with adolescent idiopathic scoliosis can be managed with either a traditional open approach or a minimally invasive approach. The data suggests that open surgery offers an advantage in terms of curve correction, compared to minimally invasive surgery, however more investigation (in the form of robust randomized control trials) is needed before conclusive clinical suggestions can be recommended.