P0839 - Minimally Invasive Surgery in Patients with Adolescent Idiopathic Scoliosis is Safer, Less Expensive with Better Restoration of Kyphosis

MIS in patients with idiopathic scoliosis is an innovative technique comparable to the standard open posterior approach. We seek to compare the two different approaches in case-control matched manner in the AIS population.
21 MIS patients were matched with 21 PSF controls based on age, Cobb angle, BMI, and levels fused. Charts and XRs were reviewed for intra-op, post op and radiographic measurements. Outcomes were analyzed on SRS 30 and a statistically validated sports activity questionnaire. OR costs (implant cost, equipment, blood products, etc.) were calculated for each surgery. Wilcoxon signed-rank tests and McNemar’s tests were utilized.
MIS patients had significantly fewer fixation points (17 vs 20, p<0.001), but a longer median anesthesia time (10 vs 7.1 hrs, p=0.005). There was no significant difference between EBL (400 vs 500cc, p=0.131), however transfusion rate was lower in MIS (1 vs 6, p=0.025). % Cobb correction, VAS score, length of stay and complications were not significant (p=0.987, p=0.187, p=0.479, p=0.317). SRS 30 and SAQ were not significantly different (p=0.902, p>0.05). OR costs in MIS were significantly lower and on average $4,200 less than the control (p<0.001).
Minimally invasive scoliosis surgery has similar radiographic, functional, and athletic return outcomes to the standard PSF approach, but significantly fewer transfusions and fixation points, and cost savings. These results suggest MIS may have economic and patient safety benefits, which need to be greatly considered.