Patient Factors Are Associated With Poor Short-term Outcomes After Posterior Fusion for Adolescent Idiopathic Scoliosis

Abstract

Background Posterior spinal fusion (PSF) is commonly performed for patients with adolescent idiopathic scoliosis (AIS). Identifying factors associated with perioperative morbidity and PSF may lead to strategies for reducing the frequency of adverse events (AEs) in patients and total hospital costs.

Predicting Short-term Morbidity in Patients Undergoing Posterior Spinal Fusion for Neuromuscular Scoliosis

“…Increased operative time and number of levels have also been previously associated with extended LOS in adolescent idiopathic scoliosis patients. 19 Readmission was associated solely with obesity in this study. As mentioned above, childhood obesity is a growing public health concern that deserves special attention and increased research in patients with NMS.…”

“…Childhood obesity has been previously associated with an increased risk of complications in adolescent idiopathic scoliosis, and is a growing concern in medicine. 19,39 Although obesity is potentially modifiable for elective procedures, it is very difficult to address in patients with neuromuscular disorders. 40 Strategies for pediatric weight loss that may be useful in a healthier pediatric population, such as weight management programs, medication, and bariatric surgery, may be unfeasible or dangerous in the NMS population.…”

“…1,12,14,[16][17][18] However, delineation of such associations is critical because short-term outcomes such as length of stay (LOS), adverse events (AEs), and readmission are associated with both poorer patient prognoses and higher hospital costs. 2,19 We therefore sought to better our understanding of NMS patient risk factors for postoperative short-term outcomes by querying a high-quality, national surgical database to determine the frequency of, and risk factors for, (1) AEs, (2) infectious complications, (3) extended LOS, and (4) readmission after PSF in patients with NMS.…”

Risk factors associated with short-term complications and mortality after pediatric spinal arthrodesis

“…1,2,5,7,10,13,14,16,17,[23][24][25] Patients undergoing spinal arthrodesis are at significant risk for developing complications and having unplanned readmissions and/ or reoperations. These clinical outcomes are undesirable for patients, physicians, and the health care system in general, as they can result in increased cost and decreased quality of life.…”

“…patients 1,2,7,16,17,[23][24][25] or a single complication, 5,10,[13][14][15] while others have been limited to single centers 5,7,9,10 or to the adult population. 7,18,20,21 Few studies have provided a comprehensive description of patient characteristics, operative factors, and comorbidities on short-term morbidity and mortality after spinal arthrodesis in children.…”