Risks for Complications After Scoliosis Surgery Identified

Complications after scoliosis surgery more likely in nonambulatory patients, large pre-op curve

FRIDAY, April 1 (HealthDay News) -- Children who undergo surgery for neuromuscular scoliosis are more likely to have major complications if they are nonambulatory and if their curve magnitude is 60 degrees or more before surgery, according to a study published in the April 1 issue of Spine.

Daniel L. Master, M.D., of the Case Western Reserve University in Cleveland, and colleagues investigated the risk factors associated with the high rate of complications following surgery for neuromuscular scoliosis. Using a computerized database, they identified 131 pediatric patients (average age, 13.4 years) with neuromuscular scoliosis who had surgery and were followed up for at least two years. They analyzed preoperative, intraoperative, and postoperative factors for associations with major complications and hospital length of stay.

The researchers found that the best indicator of elevated risk of a major complication was a preoperative curve measuring 60 degrees or more. Patients who were nonambulatory were also significantly more likely to have a major complication compared with ambulatory patients (odds ratio, 3.8). Both of these factors were indirectly linked to an increased length of hospital stay. The prevalence of major complications was 28 percent (46 complications in 37 patients), including two deaths.

"Complications associated with corrective surgery for neuromuscular scoliosis are common and can be life-threatening," the authors write. "We recommend strong consideration for operative intervention before curve progression past 60 degrees."

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