Abstract
<h3>BACKGROUND CONTEXT</h3> When examined as a collective group, NMS has a worse prognosis and surgical outcomes than its AIS counterpart. However, not all operative patients with diagnoses of cerebral palsy, Duchenne muscular dystrophy or other NMS pathology necessarily suffer similar poor outcomes associated with the class. <h3>PURPOSE</h3> Our aim is to examine more mildly affected NMS patients to determine whether their surgical outcomes are comparable to AIS with regards to patient safety. <h3>STUDY DESIGN/SETTING</h3> Ambispective review <h3>PATIENT SAMPLE</h3> Radiograph and retrospective chart review of NMS and AIS patients undergoing PSF with pedicle screws from 2005-2018 were analyzed. <h3>OUTCOME MEASURES</h3> intraoperative parameters and radiographic measurements were collected at pre- and postoperatively. <h3>METHODS</h3> Group 1 included NMS patients who could ambulate without assistance (GMFCS I-III). Group 2 was AIS patients. Demographics, Wilcoxon rank sums tests and chi-square tests were performed. <h3>RESULTS</h3> Group 1 (n = 48) and Group 2 (n = 158) were similar in age, sex, preoperative kyphosis, pre- and postoperative Cobb angle, and Cobb correction. Additionally, EBL (p=0.143), postoperative transfusions (p=0.5), and perioperative complications within 30 days (p=0.5) were similar between groups. Infections (p = 0.592), DVT (p = 0.232), revisions (p = 1.0), and mortality (p = 1.0) were statistically similar. Group 2 NMS patients did have increased fusion levels (p<0.001), fixation points (p=0.002), pelvic fixation (p=0.002), anesthesia (p<0.001) and surgery time (p<0.001), ICU (p<0.001) and hospital stay (p<0.001), intraop transfusions, pulmonary complications (p=0.012) and fewer patients extubated in the OR (p<0.001). <h3>CONCLUSIONS</h3> NMS inherently confers high risk of blood loss, longer surgeries and fusions, complications, ICU and hospitals stays. Our data confirms longer fusion levels, surgical time and hospital stay with lower extubation rates. Infection rate, revisions and overall complications were similar to AIS population as were the radiographic outcomes. This suggests that NMS patients who are ambulating can expect surgical outcomes quite comparable to AIS patients with further room for improvement in surgical duration and anesthesia protocols. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.
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