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Comparison of baseline characteristics and postoperative complications in neuromuscular, syndromic and congenital scoliosis
Journal of Pediatric Orthopaedics B ( IF 0.9 ) Pub Date : 2022-06-27 , DOI: 10.1097/bpb.0000000000000996
Lorenzo R. Deveza 1 , Barkha N. Chhabra 2 , John Heydemann 2 , Chun Hung 1 , Dallas Vanorny 1 , Dion Birhiray 2 , Benny Dahl 1, 2, 3
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Nonidiopathic scoliosis encompasses a group of diagnoses, including neuromuscular scoliosis, syndromic scoliosis and congenital scoliosis. The objective of this study was to compare the preoperative and postoperative clinical differences in pediatric nonidiopathic scoliosis patients with neuromuscular scoliosis vs. syndromic scoliosis/congenital scoliosis. This is a single-center retrospective review of all pediatric patients undergoing spinal instrumentation for nonidiopathic scoliosis during a 5-year period. Neuromuscular scoliosis patients (n = 144), syndromic scoliosis patients (n = 44) and congenital scoliosis patients (n = 52) were compared. Demographics, patient characteristics and outcomes were compared. Neuromuscular scoliosis patients had lower BMI z-scores and were more likely to have pulmonary disease, technology dependence and seizure disorder. Additionally, neuromuscular scoliosis patients underwent bigger procedures with more levels fused and a higher rate of pelvis fixation. By direct comparison, neuromuscular scoliosis patients tended to have more complications including deep surgical site infections, readmission in 30 days, return to operating room in 90 days and emergency care visits in 90 days. When controlling for the differences in their preexisting conditions and surgical procedure, we found that pelvic fixation was a major confounding factor, whereas the others had no effect. We further subanalyzed cerebral palsy patients and found this group to exhibit no difference in complications compared to other neuromuscular scoliosis subtypes. Neuromuscular scoliosis patients have different characteristics and subsequent postoperative complications than those with syndromic scoliosis and congenital scoliosis. The difference in complication profile is mainly due to differences in surgical procedure and a higher rate of pelvic fixation. This should be considered when planning nonidiopathic scoliosis surgery among multidisciplinary teams.



中文翻译:

神经肌肉、综合征和先天性脊柱侧凸的基线特征和术后并发症的比较

非特发性脊柱侧弯包括一组诊断,包括神经肌肉性脊柱侧弯、综合征性脊柱侧弯和先天性脊柱侧弯。本研究的目的是比较小儿非特发性脊柱侧弯合并神经肌肉性脊柱侧凸与综合征性脊柱侧凸/先天性脊柱侧凸的术前和术后临床差异。这是一项在 5 年内对所有因非特发性脊柱侧凸接受脊柱器械固定的儿科患者的单中心回顾性研究。神经肌肉性脊柱侧弯患者(n  = 144)、综合征型脊柱侧弯患者(n  = 44)和先天性脊柱侧弯患者(n = 52) 进行了比较。比较了人口统计学、患者特征和结果。神经肌肉性脊柱侧凸患者的 BMI z 评分较低,更有可能患有肺部疾病、技术依赖和癫痫发作。此外,神经肌肉性脊柱侧凸患者接受了更大的手术,融合了更多的水平和更高的骨盆固定率。直接比较,神经肌肉性脊柱侧凸患者往往出现更多的并发症,包括手术部位深部感染、30天再入院、90天返回手术室和90天急诊就诊。当控制他们先前存在的条件和手术程序的差异时,我们发现骨盆固定是一个主要的混杂因素,而其他因素没有影响。我们进一步对脑瘫患者进行了亚分析,发现与其他神经肌肉性脊柱侧凸亚型相比,该组在并发症方面没有差异。神经肌肉性脊柱侧凸患者与综合征型脊柱侧弯和先天性脊柱侧凸患者相比,具有不同的特征和术后并发症。并发症特征的差异主要是由于手术方式的差异和较高的骨盆固定率。在多学科团队中计划非特发性脊柱侧凸手术时应考虑到这一点。并发症特征的差异主要是由于手术方式的差异和较高的骨盆固定率。在多学科团队中计划非特发性脊柱侧凸手术时应考虑到这一点。并发症特征的差异主要是由于手术方式的差异和较高的骨盆固定率。在多学科团队中计划非特发性脊柱侧凸手术时应考虑到这一点。

更新日期:2022-07-01
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