Neurospine · Published 2026-07-30 · DOI 10.14245/ns.26520810.0405
Hong Jin Kim, Jungwook Lim, Dong Yun Kim, Joung Woo Shin, Jae Hyuk Yang, Seung Woo Suh
Objective To investigate feasibility and effectiveness of minimally invasive scoliosis surgery (MISS) via posterior approach in patients with adolescent idiopathic scoliosis (AIS) presenting with very severe curve exceeding 80°. Methods A total of 257 flexible AIS patients who underwent deformity correction using posterior MISS were retrospectively categorized into 3 groups based on the curve magnitude: moderate (M group, main Cobb angle <60°, n=142), severe (S group, 60°–80°, n=91), and very severe (VS group, ≥80°, n=24). Radiological parameters, perioperative outcomes, and complication rates were compared among the 3 groups. Results The VS group required significantly longer operative times (p<0.001), more fused segments (p<0.001), and a greater number of rib resections during thoracoplasty (p=0.032) compared to the other groups. Despite these surgical demands, there were no statistical differences in the correction rate (p=0.954) and last follow-up thoracic kyphosis (p=0.830) among the 3 groups. Regarding complications, while the overall complication rate showed no statistical difference, the VS group required significantly more invasive management for pleural effusions (p=0.012). Conclusion Posterior MISS demonstrated acceptable radiological and perioperative outcomes even in flexible AIS with Cobb angles ≥80°. These findings suggest the posterior MISS can be a feasible surgical option for selected very severe AIS patients with sufficient flexibility.
Abstract from DOAJ. Public domain (CC0 1.0).
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Kim, H., Lim, J., Kim, D., et al. (2026). Feasibility of Minimally Invasive Scoliosis Surgery in Adolescent Idiopathic Scoliosis Exceeding 80° of Curve Magnitude. Neurospine. https://doi.org/10.14245/ns.26520810.0405