Problems Following Pediatric Scoliosis Surgery
In this study, the records of 126 children with scoliosis who had surgery were reviewed. The researchers were looking for any problems that occurred right after the operation. Risk factors for those problems were also identified.
The goal is to develop a course-prediction model. This type of model could help predict outcomes of pediatric scoliosis surgery. Prevention of such problems is the main purpose of such a model.
Results showed that children with neuromuscular types of scoliosis were more likely to develop problems. This was compared with children who had idiopathic scoliosis. Idiopathic means of unknown cause.
Children with scoliosis caused by neuromuscular conditions such as cerebral palsy often have other medical problems as well. This puts them at increased risk for postoperative complications.
The most common immediate problems included bleeding, blood clots, and respiratory distress. Lung puncture and pneumonia were reported in one-third of the children. Oxygen was needed in the case of some lung complications.
There were fewer problems in patients who had a posterior fusion. This was compared with patients who had an anterior fusion or combined anterior-posterior fusion. The number of vertebrae fused did not appear to be a risk factor for problems after surgery.
The authors conclude that scoliosis surgery is a safe procedure. But problems can occur, and steps must be taken to prevent them. Patients with neuromuscular scoliosis must be followed carefully. Posterior spinal fusion is the preferred approach for most pediatric scoliosis surgeries.
Further study is needed to complete the course-prediction model. Other risk factors must be identified. Reducing length of hospitalization, costs, and post-operative problems while providing a safe and effective operation is the final outcome.
References: Roei Hod-Feins, MD, et al. Risk Factors Affecting the Immediate Postoperative Course in Pediatric Scoliosis Surgery. In Spine. October 1, 2007. Vol. 32. No. 21. Pp. 2355-2360.
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