Adolescent scoliosis

MIS techniques and principles are beginning to be applied to pediatric spinal deformity. Less invasive methods of performing traditional open anterior and posterior spinal fusions have been utilized. Thoracoscopic techniques have been utilized to perform anterior surgeries for more than a decade. Several early series of less invasive posterior spinal fusions have shown promise for their abilities to decrease surgical blood loss and speed recovery. The authors discuss their preferred less invasive technique for posterior spinal fusion. The technique involves a single midline incision and preservation of the midline attachments. Pedicle screws and then rods are placed transmuscularly. Several surgeons are also adapting the MIS principles of preservation of structural anatomy and motion in innovative ways, including vertebral body stapling and anterior vertebral tethering. We discuss our results and technique for vertebral body stapling.