00:00

Anterior release of scoliosis (access by thoracotomy)

Overview

Subscribe to get full access to this operation and the extensive Spine Surgery Atlas.

SUBSCRIBE

Learn the Anterior release of scoliosis (access by thoracotomy) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Anterior release of scoliosis (access by thoracotomy) surgical procedure.

An anterior approach to the thoracic spine can be used for a number of conditions including deformity, tumour, trauma, infection, and disc pathology.  In this feature the technique is used to achieve an anterior release as the first stage of treating severe adolescent idiopathic scoliosis measuring over 100 degrees.  I discuss the indications and considerations around the operation and demonstrate the approach via thoracotomy.

The technique allows the discs and rib heads to be removed around the apex of the curve which increases the flexibility of the spine which can increase the curve flexibility and also increase thoracic kyphosis at the time of definitive posterior fusion.  These issues are important to allow satisfactory post-operative spinal alignment in both the sagittal and coronal planes.  Following this anterior release, the patient underwent a second stage posterior spinal fusion (scoliosis correction).

I consider using this technique in adolescent idiopathic scoliosis for patients with a large rigid scoliosis where the pre-operative curve Cobb angle is more than 100 degrees and does not reduce by more than 50% on a traction film.  In scoliosis, the thoracic spine often develops a hypokyphosis which can worsen when coronal correction is performed; anterior release is a kyphosing operation and allows improved restoration of normal thoracic kyphosis.  Since there are risks associated with this procedure, the potential benefits need to be weighed against the risks involved.

 

Author:Mr Stephen Morris FRCS(Tr & Orth).

Institution: The Avon Orthopaedic centre, Southmead hospital, Bristol, UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity

COURSE

Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.

COURSE PROGRESS

  • Did you find this technique helpful?
  • YesNo

Lessons Status
QuizzesStatus
  • Did you find this technique helpful?
  • YesNo

Accreditations

Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo