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- Title
Incidence of complications in the management of non-ambulatory neuromuscular early-onset scoliosis with a rib-based growing system: high- versus low-tone patients.
- Authors
Ramirez, Norman; Olivella, Gerardo; Rodriguez, Omar; Marrero, Pablo; Smith, John; Garg, Sumeet; Vitale, Michael; St. Hilaire, Tricia; Betz, Randal
- 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.
- Subjects
PELVIC surgery; RIB surgery; SURGICAL complication risk factors; MORTALITY risk factors; AGE distribution; BODY weight; LONGITUDINAL method; ORTHOPEDIC implants; POSTOPERATIVE period; COMPLICATIONS of prosthesis; SCOLIOSIS; SEX distribution; STATURE; SURGICAL site infections; SURGICAL therapeutics; TREATMENT effectiveness; DISEASE incidence; REFUSAL to treat; RETROSPECTIVE studies; MEDICAL device removal; PREOPERATIVE period; SURGICAL blood loss; DISEASE risk factors
- Publication
European Journal of Orthopaedic Surgery & Traumatology, 2020, Vol 30, Issue 4, p621
- ISSN
1633-8065
- Publication type
Article
- DOI
10.1007/s00590-019-02614-0