Does Spinal Fusion Influence Quality of Life in Neuromuscular Scoliosis?

Mercado, Eyal; Alman, Benjamin A.; Wright, James G.

doi:10.1097/brs.0b013e318134eabe

Cited by 66 publications

(40 citation statements)

References 36 publications

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“…12 Bohtz et al 15 reviewed 50 children with CP who underwent spinal fusion and reported an improvement in QoL following surgery. Tsirikos et al 13 compared parents' and professional caretakers' satisfaction after spinal fusion in children with spasticity with those of therapists and educators by means of a nonvalidated telephone questionnaire.…”

Section: Discussionmentioning

confidence: 98%

A Preliminary Study to Assess Whether Spinal Fusion for Scoliosis Improves Carer-assessed Quality of Life for Children With GMFCS Level IV or V Cerebral Palsy

Sewell

Malagelada

Wallace

et al. 2016

Journal of Pediatric Orthopaedics

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Section: Discussionmentioning

confidence: 98%

A Preliminary Study to Assess Whether Spinal Fusion for Scoliosis Improves Carer-assessed Quality of Life for Children With GMFCS Level IV or V Cerebral Palsy

Sewell

Malagelada

Wallace

et al. 2016

Journal of Pediatric Orthopaedics

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“…While scoliosis surgery promises improvement in functional level, cosmesis, respiratory status, pain, health status, and overall quality of life [1][2][3][4][5][6], it is also affiliated with a high risk of peri-and postoperative complications [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years

et al. 2012

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Purpose Our objectives were primarily to review the published literature on complications in neuromuscular scoliosis (NMS) surgery and secondarily, by means of a meta-analysis, to determine the overall pooled rates (PR) of various complications associated with NMS surgery. Methods PubMed and Embase databases were searched for studies reporting the outcomes and complications of NMS surgery, published from 1997 to May 2011. We focused on NMS as defined by the Scoliosis Research Society's classification. We measured the pooled estimate of the overall complication rates (PR) using a random effects meta-analytic model. This model considers both intra-and inter-study variation in calculating PR. Results Systematic review and meta-analysis were performed for 68 cohort and case-control studies with a total of 15,218 NMS patients. Pulmonary complications were the most reported (PR = 22.71 %) followed by implant complications (PR = 12.51 %), infections (PR = 10.91 %), neurological complications (PR = 3.01 %) and pseudoarthrosis (PR = 1.88 %). Revision, removal and extension of implant had highest PR (7.87 %) followed by malplacement of the pedicle screws (4.81 %). Rates of individual studies have moderate to high variability. The studies were heterogeneous in methodology and outcome types, which are plausible explanations for the variability; sensitivity analysis with respect to age at surgery, sample size, publication year and diagnosis could also partly explain this variability. In regard to surgical complications affiliated with various surgical techniques in NMS, the level of evidence of published literature ranges between 2? to 2-; the subsequent recommendations are level C. Conclusion NMS patients have diverse and high complication rates after scoliosis surgery. High PRs of complications warrant more attention from the surgical community. Although the PR of all complications are affected by heterogeneity, they nevertheless provide valuable insights into the impact of methodological settings (sample size), patient characteristics (age at surgery), and continual advances in patient care on complication rates.

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“…51 At this time, simple interventions, such as chair modifications, should be investigated as possible means for shifting the trunk to improve coronal balance and sitting function before surgical intervention. 52 Hip dislocation or subluxation is a frequent condition in patients with SB, and it can affect up to 36% of children, depending on neurological level. 53 However, some controversy exists over the criteria for the selection of patients with MMC for surgical interventions on the hip.…”

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confidence: 99%

Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review

Marreiros

Loff

Calado

2014

The Journal of Spinal Cord Medicine

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Introduction: Children with myelomeningocele (MMC) are usually subjected to multiple surgeries. However, the number and type of surgeries are not the same in every patient with MMC over time. This report summarizes the surgical interventions in a cohort of several ages. Materials and methods: Data on all of the patients with MMC, aged from 1 year and 10 months to 21 years and 11 months, were retrospectively reviewed at the Dona Estefânia Hospital in Lisbon, Portugal. Data were collected by chart review and individual interviews. The factors analyzed were demographics, ambulatory status, neurological level of involvement, shunt status, Arnold-Chiari malformation type II, surgical history, and occurrence of fracture. The surgical interventions were categorized as neurosurgical, orthopedic, urinary, ulcer repair and others. Results: A total of 84 alive were eligible and enrolled. The average age was 14 years and six months. A total of 59 patients received shunts (all but one ventriculoperitoneal). In the study group, the 84 patients required 663 surgeries. Neurosurgical interventions were the most frequent surgical procedure and predominated during the first 2 years of life. Surgical interventions related to shunts were the most common neurosurgical interventions. Orthopedic surgeries were more frequent in the age group 6-12 years. Urological surgeries were done mainly after 6 years of age. Surgical repair of pressure ulcers was more common after 12 years of age. Conclusions: Our study brings to light the complexity of this condition, with multiple surgeries among patients with MMC.

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Does Spinal Fusion Influence Quality of Life in Neuromuscular Scoliosis?

Abstract: : Spinal fusion improves QOL in CP (Grade C recommendation). Spinal fusion improves QOL in muscular dystrophy (Grade C recommendation). Spinal fusion does not improve QOL in spina bifida (Grade C recommendation).

Cited by 66 publications

References 36 publications

A Preliminary Study to Assess Whether Spinal Fusion for Scoliosis Improves Carer-assessed Quality of Life for Children With GMFCS Level IV or V Cerebral Palsy

A Preliminary Study to Assess Whether Spinal Fusion for Scoliosis Improves Carer-assessed Quality of Life for Children With GMFCS Level IV or V Cerebral Palsy

Prevalence of complications in neuromuscular scoliosis surgery: a literature meta-analysis from the past 15 years

Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review

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