Predicting Short-term Morbidity in Patients Undergoing Posterior Spinal Fusion for Neuromuscular Scoliosis

Basques, Bryce A.; Chung, Suyoun; Lukasiewicz, Adam M.; Webb, Matthew L.; Samuel, Andre M.; Bohl, Daniel D.; Smith, Brian G.; Grauer, Jonathan N.

doi:10.1097/brs.0000000000001093

Cited by 33 publications

(13 citation statements)

References 39 publications

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“…The rate of adverse events (pneumonia, post-operative complications) was 22.2%, which is similar to the rates of other studies 22 . Basques et al 22 found that higher levels of ASA classification were associated with longer hospital stays and higher rates of infection and adverse events. ASA classification was not evaluated in this study; however, 75% of the patients who presented complications had long hospital stays (20 days or more).…”

Section: Discussionsupporting

confidence: 89%

Correlation between the degree of correction of neuromuscular scoliosis and patient quality of life

Nordon¹,

Lugão²,

Machado³

et al. 2017

Clinics

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OBJECTIVE:There are few data on patient satisfaction with surgery for the correction of neuromuscular scoliosis or on the correlation between patient satisfaction and the degree of curve correction achieved by surgery. Our aim was to determine the correlations between both patient satisfaction and perception of quality of life and the degree of curve correction.METHODS:We interviewed 18 patients and administered a questionnaire that collected social and economic data and information about functional ability, comorbidities and satisfaction. Statistical analysis was performed using chi-square tests, Pearson correlation and paired t-tests.RESULTS:The mean correction achieved was 42.8%, i.e., 34.17 degrees. Early and late complication rates were low (11.1% each). Almost all of the patients (94.4%) were satisfied with the surgery, and expectations were met for 61.1% of them. Quality of life and aesthetics were improved in 83.4% and 94.4% of cases, respectively. No correlation was found between satisfaction and degree of correction.CONCLUSION:Our surgical results are similar to those of other studies with respect to the degree of correction and patient satisfaction. The disparity between satisfaction and fulfillment of expectations may be due to unrealistic initial expectations or misunderstanding of the objective of surgery. Our findings corroborate the hypothesis that satisfaction is multifactorial and not restricted to a quantitative goal. The satisfaction of patients who undergo operation for neuromuscular scoliosis does not depend directly on the degree of deformity correction. The relationship between satisfaction and the success of the correction procedure is complex and multifactorial.

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Section: Discussionsupporting

confidence: 89%

Correlation between the degree of correction of neuromuscular scoliosis and patient quality of life

Nordon¹,

Lugão²,

Machado³

et al. 2017

Clinics

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“…Compared to instrumented posterior fusion, instrumented posterior fusion with interbody took an average of 19 minutes of additional time (P , .001). Although operative time has been associated with an increased risk of adverse events in other studies, 34,35 the differences were not associated with different perioperative morbidity in the current study. Thus, the clinical significance of these relatively small differences is thought not to be great in this setting.…”

Section: Discussioncontrasting

confidence: 52%

Management of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options

et al. 2019

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Background: Surgical treatment for lumbar degenerative spondylolisthesis has been shown to provide better longterm outcomes than conservative treatment. However, there is variation in surgical approaches employed by surgeons. This study investigates current surgical practice patterns and compares perioperative outcomes of 3 common surgical treatments for this pathology.Methods: A survey was administered to surgeons who attended the Lumbar Spine Research Society (LSRS) meeting in 2014. Data were extracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) from 2005 to 2014 to characterize the same responses. The 2 data sets were compared. Perioperative outcomes of those in the ACS-NSQIP posterior fusion subcohorts were characterized and compared.Results: Posterior surgical approaches utilized by surgeons who responded to the LSRS survey were similar to those captured by ACS-NSQIP where 72% of those with degenerative spondylolisthesis were fused. Of those that were fused, 8% had an uninstrumented posterior fusion, 33% had an instrumented posterior fusion, and 59% had an instrumented posterior fusion with interbody. On multivariate analysis, there was no difference in risk of postoperative adverse events, readmission, or length of stay between these 3 common types of fusion.Conclusions: Practice patterns for the posterior management of lumbar degenerative spondylolisthesis were similar between LSRS survey responses and ACS-NSQIP data. The ACS-NSQIP perioperative outcome measures assessed were similar regardless of surgical technique. These findings highlight that cost-benefit considerations and longer-term outcomes have to be the measures by which surgical technique is chosen for degenerative spondylolisthesis. Lumbar Spine

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“…NSQIP-P has been used to describe adverse events following common pediatric orthopedic procedures in order to identify procedures and patient characteristics associated with an increased risk of postoperative complications [26]. Other studies have considered outcomes after specific orthopedic procedures [27][28][29], most frequently involving the spine [30][31][32][33], as well as outcomes in orthopedic patients with specific risk factors such as obesity, congenital heart disease, or cerebral palsy [34][35][36]. To our knowledge, NSQIP-P has not been used to characterize outcomes after pediatric orthopedic oncology procedures.…”

Section: Introductionmentioning

confidence: 99%

Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

Gallaway

Ahn

Callan

2020

Sarcoma

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Background. Pediatric bone and soft tissue sarcomas are rare; therefore, national registries are essential tools for orthopedic oncology research. Past studies provide excellent data on long-term prognosis and survival trends but fail to examine treatment-specific morbidity. The aim of this study is to use a national registry to describe patient demographics, comorbidities, and adverse events in the first thirty days following surgical management of pediatric bone and soft tissue sarcomas. Methods. A retrospective review of patients in the American College of Surgeons National Surgical Quality Improvement Program—Pediatrics database (NSQIP-P) was performed. The cohort was partitioned by tumor origin (bone versus soft tissue) and tumor location (axial versus appendicular). Results. One-hundred ninety-two patients were identified. Bone sarcomas were more common (71.9%) and predominately appendicular (62.3%), while soft tissue sarcomas were predominately axial (77.8%). The overall complication rate was 8.9%. The most frequent etiologies were wound dehiscence (3.6%) and infectious complications such as surgical site infections (2.6%), pneumonia (1.6%), urinary tract infections (1.6%), and C. diff colitis (1.0%). Twenty-four percent of patients experienced bleeding requiring transfusion. The unplanned readmission rate was 12.5% (3.6% related to principle procedure), and the unplanned reoperation rate was 4.7% (4.2% related to principle procedure). The mortality rate was 1.0%. Neoadjuvant chemotherapy was associated with higher rates of wound dehiscence and infectious complications. There were no differences in adverse events with respect to tumor origin or location. Conclusion. Approximately 1 in 11 pediatric patients will experience a complication in the first thirty days following surgery. However, perioperative mortality remains low. This study represents the first comprehensive review of pediatric bone and soft tissue sarcoma surgery in the NSQIP-P database. As the case volume of NSQIP-P continues to grow, NSQIP-P has the potential to become a powerful tool for pediatric orthopedic oncology research.

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Predicting Short-term Morbidity in Patients Undergoing Posterior Spinal Fusion for Neuromuscular Scoliosis

Abstract: 3.

Cited by 33 publications

References 39 publications

Correlation between the degree of correction of neuromuscular scoliosis and patient quality of life

Correlation between the degree of correction of neuromuscular scoliosis and patient quality of life

Management of Degenerative Spondylolisthesis: Analysis of a Questionnaire Study, Correlation With a National Sample, and Perioperative Outcomes of Treatment Options

Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

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