Pathways that distinguish simple from complex scoliosis repair and their outcomes

Surgical management of spinal deformities in patients with neuromuscular diseases or other underlying comorbidities is often challenging, as this population is at an increased risk of experiencing complications. Identifying these patients early on in the preoperative planning process is imperative in order to improve patient outcomes.

Many recent studies have identified risk factors associated with perioperative and postoperative complications, including neuromuscular diseases, genetic syndromes, traumatic nerve/muscle injuries, seizure disorders, decreased cognitive ability, poor pulmonary status, restrictive lung disease, history of frequent pneumonias, sleep apnea, malnutrition, cardiac disease, immune-compromised patients, social status, ambulatory status, and the complexity of the procedure itself.

Management of spinal deformities in patients with neuromuscular diseases or other underlying comorbidities must be approached cautiously and in a multidisciplinary manner. Identifying these comorbidities early on, understanding their influence on patient outcomes after spinal surgery and managing high-risk patients through a common therapeutic and clinical pathway can help to improve patient outcomes.