319. Minimally invasive surgery for neuromuscular scoliosis: a case control study of 140 consecutive patients

Abstract

BACKGROUND CONTEXT Minimally invasive surgery (MIS) has been shown to have benefits in adolescent idiopathic scoliosis (AIS) and adult scoliosis with regards to estimated blood loss (EBL), transfusion rate, pain, narcotic usage and hospital stay. These benefits are ideal for neuromuscular scoliosis (NMS) patients, who generally have larger and stiffer curves which are at risk of progression, even with bracing. PURPOSE The purpose of this study was to report a consecutive case series of NMS patients undergoing MIS or standard PSF. STUDY DESIGN/SETTING Retrospective chart review. PATIENT SAMPLE A total of 37 NMS patients treated with MIS and 103 NMS patients treated with PSF. OUTCOME MEASURES Pre- and postoperative Cobb angle, pre- and postoperative kyphosis, pre- and postoperative pelvic obliquity, perioperative complications, surgery time, EBL, transfusion rates, ICU length of stay, hospital length of stay. METHODS We retrospectively collected data of 37 consecutive patients with neuromuscular scoliosis treated with MIS using 1 incision and a muscle-splitting approach by 2 senior surgeons from 2013-2018. 103 NMS patients treated with standard PSF and pedicle screw constructs were retrospectively reviewed in comparison. RESULTS In the MIS group, respectively the control group, the mean Cobb angle was corrected from 69.9° vs 67.7° to 29.4° vs 25.4° with a mean correction of 59% vs 63%, (p CONCLUSIONS The use of MIS for patients with neuromuscular scoliosis results in a significant correction of spinal deformity, with a low EBL, a significantly lower rate of need for allogenic blood transfusion, and a shorter LOS. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.