Major complications occurred in 35% of 3-column osteotomies and at similar rates for both PSO (38%) and VCR (22%) procedures. The presence of a major complication did not affect the ultimate clinical outcomes at 2 years or more.

With long fusions to the sacrum, one should anticipate more perioperative complications, a higher pseudarthrosis rate, and perhaps more revision surgery than short fusions. Short fusions may result in a more proximal junctional kyphosis, only rarely requiring revision surgery.

The combination of OncoPanel and OncoCopy multiplex genomic assays can identify critical diagnostic, prognostic, and treatment-relevant alterations and represents an effective precision medicine approach for clinical evaluation of pediatric brain tumors.