Scoliosis Surgery: Anterior (Front) Approach and Video-Assisted Thoracoscopic Surgery (VATS)

Anterior Approach (Front)
Certain abnormal curves are ideally suited to this approach. Many thoracolumbar (thoracic-lumbar) and thoracic curves are approached this way. The instrumentation (rods) is implanted along the side of the spine. The advantages of this surgical approach over posterior approaches include better correction, less blood loss, and fewer spinal levels fused in many cases.

The anterior approach is often done using scopes and is termed video-assisted thoracoscopic surgery, or abbreviated VATS. Patients are hospitalized for three to six days.

Anterior Approach: Standard (below):

Before (45°)

After (0°)

Before

After

Video-Assisted Thoracoscopic Surgery (VATS)
This is a technique that applies to thoracic spine surgery. Not every patient with a thoracic curve is a VATS candidate. The procedure requires that one lung be temporarily deflated; some patients, due to anatomical reasons cannot have a lung deflated. Also, some curves do not allow for easy access to the spine using VATS. Of course, there are other reasons why VATS is not an option for some patients.

Small incisions called portals are made in the side of the chest. Scopes, cameras and video monitoring devices are used by the surgeon to see the spine. These devices help make spine surgery less invasive to the patient while providing equal or better results. There is minimal effect on lung (pulmonary) function with VATS as our own studies and multiple other studies have shown.

After surgery, the small incisions are well hidden by the patient's arm. Scars are much smaller and more cosmetically appealing than standard open procedures.

Video-Assisted Thoracoscopic Surgery (VATS) (below)

Before

After

Before

After

VATS (below): This 16-year-old patient is depicted in the preceding x-rays. Please note her body symmetry (left and right-sided balance) and minimal scarring.