Ureteroscopy in pediatric patients with spinal abnormalities.

Area of Science:

• Pediatric Urology
• Endourology
• Spinal Deformities

Background:

• Ureteroscopy (URS) is a standard treatment for pediatric ureteral stones.
• Anatomic variations in patients with scoliosis or spinal hardware can complicate URS.
• The impact of spinal abnormalities on URS outcomes in children is not well-established.

Purpose of the Study:

• To evaluate the safety and efficacy of URS in pediatric patients with spinal hardware or deformities.
• To compare complication rates and stone-free status between pediatric patients with and without spinal abnormalities undergoing URS.

Main Methods:

• Retrospective review of 130 ureteroscopic procedures in 102 pediatric patients.
• Patients were categorized into two groups: normal spinal anatomy and spinal abnormalities (hardware or moderate-to-severe scoliosis).
• Key parameters included demographics, stone burden, intraoperative complications, and stone-free status.

Main Results:

• Of 105 URS for stones, 9 patients had spinal abnormalities.
• Stone-free rates were 61% in normal anatomy patients vs. 35.7% in those with spinal deformities.
• Complication rates were 6.1% in normal anatomy patients vs. 40% in those with spinal deformities.

Conclusions:

• Spinal hardware and deformities are associated with increased complications and lower stone-free rates in pediatric URS.
• URS in pediatric patients with spinal deformities is less safe and efficacious than in those with normal anatomy.
• URS can still be considered a primary treatment modality in this patient group.