Medtronic Sofamor Danek, a global leader in minimally invasive surgical solutions, has pioneered the development of an endoscopic instrumentation system for scoliosis surgery. This system is designed to allow spine surgeons to correct abnormal curvatures of the spine with much smaller incisions and less damage to the muscles of the spine and rib cage than traditional "open" procedures. It should be emphasized that endoscopic instrumentation and correction of scoliosis is a very new type of scoliosis surgery, and only a small number of patients with scoliosis would be considered candidates for this type of surgical correction. However, this is still a very exciting step towards making spine surgery less traumatic and much easier for patients to tolerate.

Features and Benefits
The CD HORIZON® endoscopic approach for scoliosis incorporates all of the benefits of the open anterior spinal approach which include improved mobilization of the spine, fusion of fewer segments and excision of the growth plates in young patients that may prevent the crankshaft phenomenon. In addition, there is improved visualization of the spine, with enhanced access to the disc spaces especially at the ends of curve, without the associated risks and poor cosmetic results from a thoracotomy incision. This feature allows for expedited patient rehabilitation and earlier discharge from the hospital with greatly improved cosmetic result.

What type of surgery is the ECLIPSE™ Endoscopic System Used For?
The ECLIPSE™ Endoscopic Surgical System was designed to correct the abnormal curves in the spine that occur in a condition known as "scoliosis." Scoliosis is not a disease - it is a descriptive term. All spines have curves that normally exist in the neck, upper trunk and lower back that help the upper body maintain proper balance and alignment over the pelvis. However, when there are abnormal side-to-side (lateral) curves in the spinal column, this is referred to as scoliosis.

How do the ECLIPSE components of the CD HORIZON® Spinal System work when treating for endoscopic scoliosis?
The endoscopic correction of scoliosis is designed to allow the surgeon to accomplish all of the goals of a traditional "open" procedure, with much less trauma to the muscles of the back and the rib cage. Using an endoscopic system also offers some additional advantages, such as the ability to view the anatomy inside the chest cavity with specially designed cameras that brightly illuminate and magnify the surgical field. With this system, the surgeon makes several small incisions that are called portals, each about an inch in length, in the space between the ribs on the same side as the apex of the curve. Through these portals, the surgeon is able to use specially designed tools to remove the ligaments and discs between the vertebral bodies of the spine that are holding the spine in its abnormally curved position. This step of the surgery is called an "anterior release".

After the spine has been released, specially designed screws are inserted into each of the vertebral bodies and a rod is connected to each of the screws. With the use of special tools, the abnormal curve is corrected by locking the rod to each of the screws and with a special compression device the curve is flattened out and locked in place. Then bone graft is placed an the spine is corrected and compressed.

What are the advantages of the ECLIPSE endoscopic scoliosis surgery?
This system accomplishes all of the goals of an anterior spinal approach, which include improved mobilization of the spine, fusion of fewer segments and excision of the growth plates in young patients that may prevent the crankshaft phenomenon. In addition, there is improved visualization of the spine, with enhanced access to the disc spaces especially at the ends of curve, without the associated risks and poor cosmetic results from a thoracotomy incision. The smaller incisions and reduced trauma to the muscles and soft tissues of the rib cage make this surgery much easier for patients to tolerate. As a result, this makes rehabilitation and physical therapy after surgery much easier and less painful, and most patients are able to leave the hospital a few days earlier than if they had an "open" procedure. The surgical scars from this type of surgery are much smaller, and the cosmetic results are much better, all of which makes for very happy patients, especially when they are adolescent girls.

What are the results with ECLIPSE endoscopic scoliosis surgery?
Endoscopic scoliosis surgery has not been done for a long enough period of time for surgeons to be able to say with certainty that this technique is better than traditional surgeries. However, as surgeons continue to develop more experience with endoscopic surgery for scoliosis and other deformities there is a growing interest in these types of procedures. Recently, a few studies have been published that have shown that this type of surgery is able to achieve results that are equivalent to open procedures in terms of curve correction, operative times, blood loss and complications. For instance, in a recent publication in the Journal Spine that compared the results of open versus endoscopic anterior spinal surgery, the authors concluded, "the thoracoscopic technique is a safe and effective alternative to open thoracotomy in the approach to the anterior thoracic spine for the treatment of pediatric and adolescent spinal deformity."

How would I know if endoscopic scoliosis surgery is right for me?
If you have scoliosis and need to have an operation, your surgeon will be able to discuss what type of surgical approach is best for the type of curve that you have. He or she will be able to tell you the options that you have for having your curve corrected and whether or not an endoscopic surgery would be beneficial in your case. It needs to be re-emphasized that this technology is still very new, but the number of surgeons being trained on this procedure is increasing. Even for those surgeons who use this type of approach regularly, there are still many types of curves than can not be corrected with an endoscopic surgery and require a traditional open procedure in order to achieve the best result.