anterior surgery in the thoracic and lumbar spine: endoscopic techniques in children by alvin h....
TRANSCRIPT
![Page 1: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/1.jpg)
Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children
by Alvin H. Crawford
J Bone Joint Surg AmVolume 86(12):2752-2763
December 1, 2004
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/2.jpg)
Conventional positions for video-assisted thoracoscopic surgery.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/3.jpg)
This photograph illustrates the prone position with three portals, for suction and retraction (X), the working portal (Y), and the portal for visualization (Z).
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/4.jpg)
A view of the right side of the thoracic spine with the viewer looking upward toward the cupula.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/5.jpg)
This photograph illustrates a thoracoscopic view of a kyphotic spine after release and insertion of fibular grafts.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/6.jpg)
Radiographs of a skeletally immature child with a single overhang type of adolescent idiopathic scoliosis who was thought to be at risk for the crankshaft phenomenon.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/7.jpg)
Preoperative lateral radiograph showing thoracic lordosis.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/8.jpg)
These photographs illustrate the technique for performing release, instrumentation, and fusion for correction of idiopathic scoliosis with use of video-assisted thoracoscopic surgery.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/9.jpg)
This anteroposterior view of the spine with image-intensification allows one to determine coronal plane placement of the screw.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/10.jpg)
This image-intensifier view shows active cable compression being applied between the second and third screws.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/11.jpg)
At the completion of the procedure, the rod has been reduced into all of the screw heads and the caps have been fully engaged.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/12.jpg)
These radiographs were made of the child shown in Figs. 5-A, 5-B, 5-C, 5-D.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.
![Page 13: Anterior Surgery in the Thoracic and Lumbar Spine: Endoscopic Techniques in Children by Alvin H. Crawford J Bone Joint Surg Am Volume 86(12):2752-2763](https://reader035.vdocuments.us/reader035/viewer/2022081421/5697c0191a28abf838cceb2c/html5/thumbnails/13.jpg)
Standing posteroanterior and lateral radiographs of the spine made at one year, illustrating coronal plane correction as well as improvement in the thoracic lordosis.
Alvin H. Crawford J Bone Joint Surg Am 2004;86:2752-2763
©2004 by The Journal of Bone and Joint Surgery, Inc.