Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Paediatrics
Abstract number: 24631
COMPLICATIONS AND PATIENT SATISFACTION AFTER NEUROMUSCULAR
AND SYNDROMIC SPINAL DEFORMITY SURGERY
Richard GROSS, Carrie CORMACK, Frank ARMOCIDA
Medical University of South Carolina, Charleston (UNITED STATES)
Analysis of complications was performed in 42 cases neuromuscular (NM) scoliosis
and 18 syndromic scoliosis, all with minimum 3 year followup, one surgeon. Stainless
steel instrumentation was used for all. Questionnaire designed by authors was
completed by 48/60 patients or families (35/42 NM, 13/18 syndromic). Complications
were much more numerous and severe in neuromuscular patients. 1 major
complication, partial paraplegia, occurred in the syndromic group. In neuromuscular
group, deep wound infection requiring removal of instrumentation occurred in 11/42
patients, all with CP or spina bifida (5/18 CP, 5/6 spina bifida). All instrumentation
removed had evidence of corrosion. ½ of infections were associated with Urinary
tract infections. There was one death 2 weeks postop (NM). One patient (CP) had
a poor outcome from technical factors, with inadequate correction. One patient (CP)
with hyperkyphosis was initially paraplegic, but 2 years later she recovered her ability
to ambulate. Despite these numerous and severe complications, patient/family
satisfaction was high. 27/35 NM indicated they would definitely or probably have the
surgery performed again, 11/13 syndromic. Posture/sitting balance was judged as
major or moderately improved by by 30/35 NM, 10/13 syndromic. Of the 19 patients
with preop sleep disturbances, 15 (12/14 NM, 5/7 syndromic experienced major or
moderate improvement. Quality of life was judged as worsened postop in 5 patients.
27/35 NM and 12/13 syndromic would recommend the surgery to others. Stainless
steel is no longer used for spinal instrumentation.
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