• Scott J Luhmann and Ryan Furdock.
• Pediatric Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA. Electronic address: luhmanns@wustl.edu.
• Spine Deform. 2019 Jan 1; 7 (1): 107-111.

ObjectiveThe objective of this study is to identify preoperative laboratory values and patient factors that are associated with postoperative respiratory complications in pediatric neuromuscular scoliosis (NMS) populations undergoing posterior spinal fusion (PSF) with instrumentation.Summary Of Background DataPSF in NMS patients are high-risk surgeries. Respiratory complications are the most common postoperative event, with rates up to 28.2% following surgery.MethodsA single-surgeon, two-hospital pediatric spine surgery database was reviewed to identify all patients who underwent PSF for NMS. Diagnoses included cerebral palsy (n=83), myelomeningocele (n=13), spinal muscular atrophy (n=4), and other (n=11). This study defined respiratory complications as postoperative pneumonia, pleural effusion, pneumothorax, need for reintubation, respiratory status requiring a return to the pediatric intensive care unit (PICU), or prolonged (>4-day) need for mechanical ventilation. Preoperative laboratory values for transferrin, prealbumin, hemoglobin/hematocrit, total protein, albumin, and total lymphocyte count were collected.ResultsThere were 50 males and 61 females with a mean age of 14 years 2.5 months (8-20 years). Seventeen patients (15.3%) experienced postoperative respiratory complications. On univariate analysis, any history of pneumonia, the presence of gastrostomy tube, and low transferrin levels were associated with postoperative respiratory complications, and a strong trend (p=.06) was observed for tracheostomy. On multivariate analysis, the presence of gastrostomy tube and history of pneumonia remained as clinically significant predictors of postoperative respiratory complications.ConclusionPediatric NMS patients undergoing PSF that have history of pneumonia or gastrostomy tube present at time of surgery are at increased risk for postoperative respiratory complications. The univariate associations of tracheostomy presence and low transferrin levels with postoperative respiratory complications deserve further examination.Level Of EvidenceLevel II.Copyright © 2018 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

50 keywords...

hide…