P89. Increased complications in pediatric patients with non-idiopathic scoliosis undergoing spinal instrumentation for neuromuscular scoliosis compared to syndromic and congenital scoliosis

Abstract

BACKGROUND CONTEXT Non-idiopathic scoliosis encompasses a group of diagnoses including neuromuscular, syndromic and congenital scoliosis. It is known that those with neuromuscular scoliosis have increased complications in comparison to those with idiopathic scoliosis. However, patients diagnosed with syndromic or congenital scoliosis do not share the same characteristics and are often treated similarly to those with neuromuscular scoliosis. The clinical differences between pediatric patients with neuromuscular scoliosis and syndromic/congenital scoliosis are not well described. PURPOSE To assess differences in pediatric non-idiopathic scoliosis patients with neuromuscular scoliosis (NM) vs syndromic and congenital scoliosis (SS/CS). STUDY DESIGN/SETTING Retrospective cohort study at a single pediatric institution analyzing all cases involving spinal instrumentation for non-idiopathic scoliosis comparing NM and SS/CS patients. PATIENT SAMPLE All pediatric patients undergoing spinal instrumentation (n=251) for non-idiopathic scoliosis at a single institution from 2012-2016. OUTCOME MEASURES Intraoperative estimated blood loss by patient weight (ml/kg); Postoperative blood transfusion (ml); mortality at 30 days and 1 year; surgical site infections (SSI); revision surgery and instrument failure in 1 year; readmission in 30 days; return to OR and emergency room visits in 90 days. METHODS This is a retrospective review of all pediatric patients undergoing spinal instrumentation for non-idiopathic scoliosis. Neuromuscular scoliosis (NM) patients (n=112 patients, 128 cases) were compared against syndromic and congenital scoliosis (SS/CS) patients (n=62 patients, 69 cases). Demographics, patient characteristics and outcomes were compared. Variables were analyzed by students' t-test and Categorical variables were analyzed by Chi-Square Test. RESULTS NM patients were older than those with SS/CS (13.3±3.5 NM vs 11.7±3.5 SS/CS, p=0.002). There were no differences in gender and BMI. In terms of pre-existing conditions, there was a higher percentage of NM patients with pulmonary disease (61.2% NM vs 24.3% SS/CS, p CONCLUSIONS Non-idiopathic patients with NM scoliosis have different patient characteristics and subsequent postoperative complications than those with SS and CS. NM patients are more likely to have pulmonary disease and seizures. Intra-operatively, NM patients have more blood loss. Postoperatively, NM patients have more complications including SSI, readmission and return to OR at 90 days. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.