Pediatric Scoliosis Surgery - The Association between Preoperative Risk Factors and Postoperative Complications with Emphasis on Cerebral Palsy Children

Abstract

Scoliosis repair surgery is a common procedure. Our study's first goal was to compare pre- and postoperative parameters between the cerebral palsy (CP) and idiopathic scoliosis (IS) children. The second goal was to establish possible associations between preoperative parameters that could predict the outcome of spinal surgery and the incidence of early postoperative complications. A retrospective record review of all children who underwent scoliosis operative surgery between 1998 and 2007 was conducted. Of the 141 children included, 21 were CP and 120 were IS. The CP children attended surgery with significantly lower weight and pulmonary reserves and had larger curves and fusions compared to the IS children. CP children had a significantly higher rate of major complications, especially pulmonary and neurological, and a higher rate of delayed extubations. In addition, young age at surgery and posterior spinal fusion correlated with a more favorable immediate postoperative prognosis among the IS population. CP children attended surgery in worse physical condition and in turn had a poorer immediate and short-term postoperative prognosis than IS children. Young age at surgery and posterior fusions revealed protective characteristics among the IS population.

Do Multilevel Ponte Osteotomies in Thoracic Idiopathic Scoliosis Surgery Improve Curve Correction and Restore Thoracic Kyphosis?

“…Significant operative time (often >6-8 h), blood loss (500-2500 mL), 12-17 and complications [18][19][20][21] have been reported in scoliosis surgery. Significant operative time (often >6-8 h), blood loss (500-2500 mL), 12-17 and complications [18][19][20][21] have been reported in scoliosis surgery.…”

Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years

“…The diagnosis of NMS itself is the most significant risk factor for peri-and postoperative complications [11,29,30]. NMS is associated with lengthier hospital stay and a five-fold higher frequency of death [10].…”

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

“…Such factors are not only important clinically and for setting appropriate patient expectations, but they also are closely tied to total hospital costs associated with the procedure [30]. The information we have on risk factors for AEs in patients undergoing PSF have been derived mainly from studies that either were limited by small sample size [21,41,44,54], only studied one variable [2,16,25,29,31,42,44,45,50,55], included patients with neuromuscular scoliosis and cerebral palsy [5,19,20,24,32,43], used potentially flawed administratively coded or self-reported data [5,7,35,51], or included adult patients with deformity [35].…”