Factors Predicting Postoperative Complications Following Spinal Fusions in Children with Cerebral Palsy

Optimizing Perioperative Nutrition in Pediatric Populations

“…Lipton et al 45 noted a lower rate of infection in their population of children with CP undergoing spinal surgery compared with previous reports of infection rate, which may be associated with their nutrition plan that included nasogastric tube feeding as soon as bowel function returned. For children who had a poor nutrition status prior to the surgery, or if an ileus was anticipated for a long period, PN was initiated.…”

“…The patient spent 22 days in the hospital following surgery. Patient's length of stay (LOS) compares with that of a retrospective study by Lipton et al, 45 in which 107 patients were evaluated following spinal fusion surgery. The average LOS was 23 days, 2 hours.…”

Outcomes after scoliosis surgery for children with cerebral palsy: a systematic review

“…There was inconsistency with respect to reporting type of complications, for example major versus minor and the classification of complications, such as respiratory or neurological. Major versus minor classification was used in eight studies; however, among these studies there were five different definitions of what constituted a major or minor complication. Types of complications are reported in Table SIII (online supporting information).…”

“…Eighteen studies reported preoperative factors for poor postoperative outcomes; however, only 11 of these reported statistical associations or correlations separately for CP samples (Table SIV, online supporting information) . Comorbidities including gastrointestinal issues, respiratory conditions, seizures, malnutrition, intellectual disability, reduced speech ability, and prior surgical infection were identified as risk factors in addition to an increased weight, older age, higher preoperative platelet or white cell count, and the type or severity of preoperative spinal or pelvic deformity.…”

“…Promisingly, these studies have a greater focus on QoL, activity, and participation outcomes, as well as consideration of the importance of pelvic obliquity correction in this population . Systematic means of determining risk of complications are also re‐emerging with the use of a preoperative risk score and postoperative complications score in a recent study, first used in 1999 . The Clavien‐Dindo scale, an established tool for classifying surgical complications has also been used in another recent study examining complications after neuromuscular scoliosis surgery …”