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Updated: Nov 16, 2025
Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025
Short-term surgical complications of spinal fusion in myelomeningocele
Alex Oliveira de Araújo1, Cícero Ricardo Gomes1, Daniela Fava1
1Department of Orthopedic Surgery, Pediatrics and Rehabilitation, SARAH Network of Rehabilitation Hospitals, SMHS Qd 301 Bloco A, Brasília, DF, 70335-901, Brazil.
Study Design:
Retrospective review of a prospective database.
Purpose:
To determine the rate of short-term surgical complications in the 3-month postoperative period in patients with myelomeningocele (MMC) who underwent surgical correction of spine deformities.
Methods:
This study reviewed the medical records of MMC patients, aged ≤ 18 years, who underwent spine deformity correction between 2012 and 2018. Clinical, radiological, and surgical variables were considered.
Results:
Forty-six patients with primary preoperative curve, pelvic obliquity, and kyphosis mean values of 84.9º, 21.5º, and 76.1º, respectively, were included. Thirty-four (74%) patients underwent scoliosis correction and 12 (26%), kyphectomy. A trend in reduction of %EBV (estimated blood volume) loss with antifibrinolytic use from 50.2 ± 32.3 to 33.8 ± 17.2% was observed (p = 0.103). Simultaneous detethering was performed in 13 (27.7%) patients and was not associated with higher short-term complication rates. There were 12 cases of short-term surgical complications (26.1%); among them, six had deep wound infection requiring surgical debridement, and one a superficial wound infection. Drainage time longer than 4 days was significantly associated with wound infection (OR = 15.8, p = 0.01).
Conclusions:
The surgical treatment of neuromuscular scoliosis in MMC patients is challenging because of the high comorbidity rate. Still, we found an admissible rate of short-term surgical complications with a multidisciplinary approach in a setting with extensive spine deformity surgery experience.
Insights
Surgical correction of spine deformities in myelomeningocele (MMC) patients showed an admissible rate of short-term complications. Wound infection was linked to longer drainage times, highlighting the need for careful postoperative management in these complex cases.
Area of Science:
- Pediatric Orthopedics
- Neurosurgery
- Spine Surgery
Background:
- Myelomeningocele (MMC) is associated with significant spinal deformities.
- Surgical correction of these deformities in MMC patients presents unique challenges due to high comorbidity.
- Understanding short-term surgical complication rates is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine the incidence of short-term surgical complications within 3 months post-surgery.
- To evaluate the safety and efficacy of spine deformity correction in pediatric patients with MMC.
- To identify factors associated with surgical complications in this population.
Main Methods:
- Retrospective review of a prospective database.
- Analysis of clinical, radiological, and surgical data from 46 pediatric patients (≤18 years) with MMC undergoing spine deformity correction (2012-2018).
- Statistical analysis to identify complications and associated risk factors, including antifibrinolytic use and simultaneous detethering.
Main Results:
- A total of 12 short-term surgical complications (26.1%) were observed.
- Deep wound infection was the most frequent complication (6 cases), requiring surgical debridement.
- Longer drainage time (>4 days) was significantly associated with increased risk of wound infection (OR=15.8, p=0.01).
Conclusions:
- Spine deformity surgery in MMC patients can achieve admissible short-term complication rates with a multidisciplinary approach.
- Experienced surgical teams and careful postoperative management, particularly regarding wound drainage, are essential.
- Despite challenges, surgical intervention offers a viable option for managing spinal deformities in this patient group.
