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Pediatric tethered cord release: an epidemiological and postoperative complication analysis
Abhiraj D Bhimani1,2, Ashley N Selner1, Jay B Patel1
1Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA.
Journal of Spine Surgery (Hong Kong)
|October 31, 2019
Summary
Tethered cord release (TCR) is common in pediatric neurosurgery. While generally safe, females face higher postoperative complication risks, despite males having more pre-operative comorbidities.
Area of Science:
- Pediatric Neurosurgery
- Surgical Quality Improvement
- Clinical Outcomes Research
Background:
- Tethered cord release (TCR) is a frequent pediatric neurosurgery procedure.
- Risk factors for postoperative complications after TCR are not well-defined.
- Understanding these risks is crucial for improving patient safety.
Purpose of the Study:
- To identify demographics and risk factors associated with 30-day postoperative complications following pediatric TCR.
- To analyze reasons for readmission and reoperation after TCR.
- To provide a contemporary analysis of TCR outcomes in a large pediatric cohort.
Main Methods:
- Utilized the American College of Surgeons-National Surgical Quality Improvement Program Pediatric Database (ACS-NSQIP-P).
- Included 3,682 pediatric patients undergoing TCR.
- Employed univariate and multivariate analyses to assess risk factors and complications.
Main Results:
- Males undergoing TCR were younger and had more pre-operative comorbidities but fewer complications than females.
- Factors associated with complications included intraoperative microscope use, longer operative times, and worse preoperative ASA class.
- Females demonstrated a higher rate of 30-day postoperative complications.
Conclusions:
- Pediatric TCR is relatively safe but carries inherent risks.
- Males present with more pre-operative risk factors, while females experience higher postoperative complication rates.
- This study offers a large, multi-institutional dataset for future TCR outcome research.
