P125. Concurrence presence of thoracolumbar scoliosis and Arnold Chiari Malformation: is operative risk magnified

Abstract

BACKGROUND CONTEXT Scoliosis is frequently associated with Chiari malformation (CM). More specifically, reports have been made about this association with CM-1 in the absence of syrinx status. There is paucity in literature in the surgical risks associated with concurrent CM types and scoliosis diagnosis. PURPOSE To identify the risks adolescent patients have when diagnosed with CM and scoliosis. STUDY DESIGN/SETTING Adolescents in pts in Kids’ Inpatient Database (KID) during the years of 2003-2012. PATIENT SAMPLE A total of 35,073 Chiarim pts. OUTCOME MEASURES Complications. METHODS CM and scoliosis pts were isolated in KID from 2003-2012. The patients were stratified into three groups: those with concomitant CM and scoliosis (CmS), those with only CM (OCm), and those with only scoliosis (Scol). Demographics, incidence, comorbidity profiles, surgical strategy, and postoperative complications were assessed. Comorbidity profiles were stratified by body systems (neurological, musculoskeletal, pulmonary, cardiovascular, renal). Groups were compared using t-tests and chi-squared tests for continuous and discrete variables, respectively. Multivariate logistic regressions were used to assess association between surgical characteristics/diagnosis with complication rate. RESULTS Included 90,707 spine pts, 63.3% Scol, 38.7%Ocm, and 2.0%Cms. Scol were older (13.6yrs vs CM: 5.9 vs Both:10.9) and had a higher invasiveness score (2.4 vs OCm: 0.5 vs Both:1.5), while CmS pts were more comorbid (0.9 vs OCm: 0.55 vs Scol: 0.89; all p CONCLUSIONS Having concurrent scoliosis and Chiari malformation increases operative risk for when decompressive surgeries are performed. Being independently inflicted with scoliosis or Chiari leads to increased complication rate when paired with fusion surgeries. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.