@article{6029c62ea2f34c30b4280a5a28f54363,
title = "Major complications following surgical correction of spine deformity in 257 patients with cerebral palsy",
abstract = "Study design: Observational. Objectives: To report on the rate of major complications following spinal fusion and instrumentation to treat spinal deformity in patients with cerebral palsy (CP). Summary of background data: Understanding the risk of major complications following the surgical treatment of spine deformities in patients with CP is critical. Methods: A prospectively collected, multicenter database of patients with CP who had surgical correction of their spinal deformity (scoliosis or kyphosis) was reviewed for all major complications. Patients with ≥ 2 year follow-up or who died ≤ 2 years of surgery were included. A complication was defined as major if it resulted in reoperation, re-admission to the hospital, prolongation of the hospital stay, was considered life-threatening, or resulted in residual disability. Overall complication and revision rates were calculated for the perioperative (Peri-op; occurring ≤ 90 days postoperative) and delayed postoperative (Delayed; > 90 days) time periods. Results: Two hundred and fifty-seven patients met inclusion. Seventy-eight (30%) patients had a major complication, 18 (7%) had > 1. There were 92 (36%) major complications; 64 (24.9%) occurred Peri-op. The most common Peri-op complications were wound (n = 16, 6.2%) and pulmonary issues (n = 28, 10.9%), specifically deep infections (n = 12, 4.7%) and prolonged ventilator support (n = 21, 8.2%). Delayed complications (n = 28, 10.9%) were primarily deep infections (n = 8, 3.1%) and instrumentation-related (n = 6, 2.3%). There were 42 additional surgeries for an overall unplanned return to the operating room rate of 16% (Peri-op: 8.6%, Delayed: 7.8%). Thirty-six (14.0%) reoperations were spine related surgeries (wound or instrumentation-related). Eleven (4.3%) patients died between 3 months to 5.6 years postoperatively; 4 occurred ≤ 1 year of surgery. Two deaths were directly related to the spinal deformity surgery. Conclusion: Spinal deformity surgery in CP patients with greater than 2 years of follow-up have a postoperative major complication rate of 36% with a spine-related reoperation rate of 14.0%. Level of evidence: Therapeutic-IV.",
keywords = "Cerebral palsy, Complications, Deformity, Fusion, Neuromuscular scoliosis",
author = "Burt Yaszay and Bartley, {Carrie E.} and Sponseller, {Paul D.} and Mark Abel and Cahill, {Patrick J.} and Shah, {Suken A.} and Firoz Miyanji and Samdani, {Amer F.} and Carlie Daquino and Newton, {Peter O.}",
note = "Funding Information: This study was supported in part by grants to the Setting Scoliosis Straight Foundation from DePuy Synthes Spine, EOS imaging, K2M, Medtronic, NuVasive and Zimmer Biomet in support of Harms Study Group research. Acknowledgements Funding Information: Harms Study Group Investigators: Aaron Buckland, MD; New York University. Amer Samdani, MD; Shriners Hospitals for Children—Philadelphia. Amit Jain, MD; Johns Hopkins Hospital. Baron Lonner, MD; Mount Sinai Hospital. Benjamin Roye, MD; Columbia University. Burt Yaszay, MD; Rady Children{\textquoteright}s Hospital. Chris Reilly, MD; BC Children{\textquoteright}s Hospital. Daniel Hedequist, MD; Boston Children{\textquoteright}s Hospital. Daniel Sucato, MD; Texas Scottish Rite Hospital. David Clements, MD; Cooper Bone & Joint Institute New Jersey. Firoz Miyanji, MD; BC Children{\textquoteright}s Hospital. Harry Shufflebarger, MD; Nicklaus Children{\textquoteright}s Hospital. Jack Flynn, MD; Children{\textquoteright}s Hospital of Philadelphia. Jahangir Asghar, MD; Cantor Spine Institute. Jean Marc Mac Thiong, MD; CHU Sainte-Justine. Joshua Pahys, MD; Shriners Hospitals for Children—Philadelphia. Juergen Harms, MD; Klinikum Karlsbad-Langensteinbach, Karlsbad. Keith Bachmann, MD; University of Virginia. Larry Lenke, MD; Columbia University. Mark Abel, MD; University of Virginia. Michael Glotzbecker, MD; Boston Children{\textquoteright}s Hospital. Michael Kelly, MD; Washington University. Michael Vitale, MD; Columbia University. Michelle Marks, PT, MA; Setting Scoliosis Straight Foundation. Munish Gupta, MD; Washington University. Nicholas Fletcher, MD; Emory University. Patrick Cahill, MD; Children{\textquoteright}s Hospital of Philadelphia. Paul Sponseller, MD; Johns Hopkins Hospital. Peter Gabos, MD: Nemours/Alfred I. duPont Hospital for Children. Peter Newton, MD; Rady Children{\textquoteright}s Hospital. Peter Sturm, MD; Cincinnati Children{\textquoteright}s Hospital. Randal Betz, MD; Institute for Spine & Scoliosiscba. Ron Lehman, MD; Columbia University. Stefan Parent, MD: CHU Sainte-Justine. Stephen George, MD; Nicklaus Children{\textquoteright}s Hospital. Steven Hwang, MD; Shriners Hospitals for Children—Philadelphia. Suken Shah, MD; Nemours/Alfred I. duPont Hospital for Children. Tom Errico, MD; Nicklaus Children{\textquoteright}s Hospital. Vidyadhar Upasani, MD; Rady Children{\textquoteright}s Hospital Publisher Copyright: {\textcopyright} 2020, Scoliosis Research Society.",
year = "2020",
month = dec,
doi = "10.1007/s43390-020-00165-7",
language = "English (US)",
volume = "8",
pages = "1305--1312",
journal = "Spine deformity",
issn = "2212-134X",
publisher = "Elsevier BV",
number = "6",
}