BACKGROUND CONTEXT It is well known that patients with NMS are victims of severe pathological progression. 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 the same poor outcomes associated with the class. PURPOSE Our aim with this study is to examine more mildly affected NMS patients to determine whether their surgical outcomes are comparable to AIS with regards to patient safety. STUDY DESIGN/SETTING Retrospective review from prospectively collected database. PATIENT SAMPLE A total of 48 NMS and 158 AIS patients OUTCOME MEASURES Perioperative complications (infection, pulmonary, DVT, neurologic, cardiovascular, revision) METHODS Radiograph and retrospective chart review of NMS and AIS patients undergoing PSF with pedicle screws from 2005-2018 were analyzed. Group 1 included NMS patients who could ambulate without assistance (GMFCS I-III). Group 2 was AIS patients. Demographics, intra-op parameters, and radiographic measurements were collected at pre- and post-op. Wilcoxon rank sums tests and chi-square tests were performed. RESULTS 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 (600mL vs 500mL; p=0.143), postoperative transfusions (4 vs 9; p=0.5), and perioperative complications within 30 days (4 vs 10; p=0.5) were similar between groups. Specifically, infections (0 vs 5; p = 0.592), DVT (0 vs 1;p = 0.232), revisions (1 vs 4; p = 1.0), and mortality (p = 1.0) were statistically similar. However, group 2 NMS patients did have increased fusion levels (p CONCLUSIONS NMS inherently confers high risk of blood loss, longer surgeries and fusions, complications, ICU and hospitals stays. Our data confirm longer fusion levels, surgical time, and hospital stay, with lower extubation rates. Infection rate, revisions and overall complications were similar to the 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. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.