Incidence of complications in the management of non-ambulatory neuromuscular early-onset scoliosis with a rib-based growing system: high- versus low-tone patients

Norman Ramirez, Gerardo Olivella, Omar Rodriguez, Pablo Marrero, John Smith, Sumeet Garg, Michael Vitale, Tricia St. Hilaire, Randal Betz

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: The purpose of this study is to evaluate whether patients with high-tone neuromuscular early-onset scoliosis have different surgical outcome and complication rate, when compared to patients with low-tone neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. Methods: This is a retrospective cohort study of 67 neuromuscular early-onset scoliosis patients, collected from a multicenter database, treated with a rib-to-pelvis rib-based dual growing system. All patients were divided into two groups: high tone and low tone. Pre-, intra- and postoperative data were compared between both groups. Complications were reported by a standardized system. Results: Twenty-six high-tone and 41 low-tone patients were found homogeneous regarding gender, age at surgery, weight, height, estimated blood loss and surgery time. High-tone group (19/26 = 73.1%) experiences more postoperative complications than low-tone group (22/41 = 53.7%). Most common complications were infection, device migration, death and hardware failure. Permanent abandonment of rib-based growing technique and device removal was required in 21% of high-tone patients (P < 0.001). None of the low-tone patients required abandonment. Conclusion: High-tone patients had more complications than those with low tone in management of neuromuscular early-onset scoliosis treated with a rib-to-pelvis rib-based dual growing system. A different surgical approach may be required to treat the high-tone neuromuscular early-onset scoliosis.

Original languageEnglish
Pages (from-to)621-627
Number of pages7
JournalEuropean Journal of Orthopaedic Surgery and Traumatology
Volume30
Issue number4
DOIs
StatePublished - 1 May 2020
Externally publishedYes

Keywords

  • Early onset scoliosis
  • Neuromuscular scoliosis
  • Rib-based growing system

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