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

Life expectancy in pediatric patients with cerebral palsy and neuromuscular scoliosis who underwent spinal fusion

“…Fundoplication was performed after the scoliosis correction if reflux remained a problem. We have not found a direct correlation between complications and the presence of reflux when the reflux is under adequate medical management (Lipton et al 1999).…”

“…Respiratory factors that tend to lead to long-term ICU stays are poor oral motor airway control, chronic aspiration, and progressive pulmonary changes as a result of persistent aspiration. However, when the children are evaluated preoperatively, we have not been able to predict accurately which children will have a prolonged ICU stay and, therefore, which children will be at significant increased risk of mortality (Lipton 1999).…”

“…Scoliosis in this group of children with severe disability significantly decreases their sitting tolerance and causes pain from impingement of their pelvis against the thoracic wall on the concavity of the curve. This situation may eventually create cardiopulmonary complications, particularly when the curve magnitude is such that individuals can barely spend any time in the erect or sitting position (Lipton et al 1999). Spinal fusion is indicated in children with progressive scoliosis deformity, magnitude, and stiffness that interferes with their overall level of function (Renshaw 2001, Herring 2002, Labelle and Grimard 2002.…”

Patient Factors Are Associated With Poor Short-term Outcomes After Posterior Fusion for Adolescent Idiopathic Scoliosis

“…Such factors are not only important clinically and for setting appropriate patient expectations, but they also are closely tied to total hospital costs associated with the procedure [30]. The information we have on risk factors for AEs in patients undergoing PSF have been derived mainly from studies that either were limited by small sample size [21,41,44,54], only studied one variable [2,16,25,29,31,42,44,45,50,55], included patients with neuromuscular scoliosis and cerebral palsy [5,19,20,24,32,43], used potentially flawed administratively coded or self-reported data [5,7,35,51], or included adult patients with deformity [35].…”

The management of scoliosis in children with cerebral palsy: a review

“…The reported overall complication rate in the literature is variable, ranging between 17-68% (67,(83)(84)(85)(86). High risk of complication is associated with non-ambulatory status and greater angle of scoliosis curve (85,87). These patients often suffer from the greatest physical disability and a number of preoperative medical comorbidities, which may account for this increased risk.…”