P0824 - Case Control Study Comparing Correction of Deformity and Perioperative Morbidity in 148 Consecutive Patients

The posterior minimally invasive surgery (MIS) approach, equivalent to a Wiltse approach, is widely used for spinal trauma, degenerative, and neoplastic cases. The potential advantages of this technique over the standard midline posterior approach are a shorter LOS associated with a reduced soft tissue trauma lowering postoperative pain, EBL and transfusion rate.
48 consecutive patients with neuromuscular scoliosis treated with MIS using one incision and a muscle-splitting approach by two senior surgeons in three tertiary medical centers between 2013 and 2018. Data was case controlled to standard PSF patients from 2005 – 2017.
Patients were similar in age, BMI, preop Cobb, and preop pelvic obliquity (p > 0.05). Postop Cobb, percentage Cobb correction, postoperative pelvic obliquity and percentage pelvic obliquity correction were similar (p > 0.05). Operative time and blood loss were significantly less for MIS patients (p < 0.001). A significantly fewer number of patients were transfused (p < 0.001) and average hospital stay was 3 days fewer (p = 0.119). Intraoperative and overall perioperative complication rate were similar between the groups (p = 0.05).
MIS used for NMS patients provided adequate radiographic correction. This technique seems to be safer than the routine posterior open approach with significantly lower EBL and need for transfusion. Hospital stay was also reduced by 3 days. The results of this study show a promising future for these high-risk patients.