Complication rate after scoliosis surgery in children with cerebral palsy

Area of Science:

• Pediatric Orthopedics
• Neurology
• Critical Care Medicine

Background:

• Scoliosis is a significant concern in children with cerebral palsy (CP), necessitating careful consideration of spinal fusion risks versus benefits.
• Preoperative assessment of surgical risks, particularly respiratory, is crucial for this vulnerable population, yet specific data for CP is limited.

Purpose of the Study:

• To investigate and compare postoperative complication rates after scoliosis surgery in children with CP versus idiopathic scoliosis (IS).
• To identify risk factors associated with common complications in children with CP undergoing spinal fusion.

Main Methods:

• Retrospective monocenter study analyzing medical records of children with CP and IS who underwent scoliosis surgery between 2010 and 2014.
• Comparison of hospitalization duration and postoperative complications within a 6-month follow-up period.
• Application of univariate and multivariate logistic regression models to identify risk factors.

Main Results:

• Children with CP exhibited higher rates of respiratory, cardiovascular complications, wound infections, and decubitus ulcers compared to IS patients (p<0.05).
• Postoperative pneumonia was the most frequent complication in both groups (43% in CP, 18% in IS).
• Epilepsy was identified as a significant risk factor for complications in children with CP (OR 3.85, p=0.037), and CP patients had longer ICU and total hospital stays (p<0.001).

Conclusions:

• Children with CP undergoing scoliosis surgery experience a greater burden of postoperative complications and extended hospitalizations.
• Epilepsy is a critical risk factor to consider in the perioperative management of CP patients with scoliosis.
• Findings provide valuable insights for perioperative care and surgical decision-making in pediatric CP patients requiring spinal fusion.