Perioperative complications and outcomes in children with cerebral palsy undergoing scoliosis surgery

Paediatr Anaesth. 2016 Oct;26(10):970-5. doi: 10.1111/pan.12981. Epub 2016 Aug 8.

Abstract

Introduction: Neuromuscular scoliosis is a known risk factor for postoperative complications after corrective spine surgery. Few studies have looked at the preoperative factors affecting postoperative complications in children with cerebral palsy.

Aim: The aim of this study was to examine the factors that might influence postoperative course in patients with cerebral palsy undergoing spine surgery for scoliosis.

Methods: Nineteen case notes of children with cerebral palsy who had spine surgery (2008-2014) were reviewed retrospectively. Preoperative comorbidities and postoperative complications were noted and complications were classified as major and minor.

Results: Thirteen out of 19 (68.4%) patients had two or more systemic comorbidities. Most common comorbidities included reflux and seizure disorder. Nine patients (49%) had at least one major complication. About 5/19 patients had respiratory complications requiring ventilation and 4/19 had massive blood loss. A higher incidence of postoperative major complication was recorded in the group with two systemic comorbidities as compared to those with less than two systemic comorbidities (47% vs 16%). Both patients who had a single-stage anterior release and posterior fixation had a major complication.

Conclusion: Presence of two or more comorbidities and thoracotomy are risk factors for perioperative complications in children with cerebral palsy undergoing surgery for scoliosis correction.

Keywords: cerebral palsy; comorbidity; postoperative complications; risk factors; scoliosis; thoracotomy.

MeSH terms

  • Adolescent
  • Adult
  • Cerebral Palsy / epidemiology*
  • Child
  • Comorbidity
  • Female
  • Humans
  • Incidence
  • Male
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Scoliosis / epidemiology*
  • Scoliosis / surgery*
  • Treatment Outcome
  • Young Adult