Complication rate after scoliosis surgery in children with cerebral palsy / Elke Vandendriessche in Acta Orthopaedica Belgica, Vol.87/2 (Juin 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 255-261 Titre : Complication rate after scoliosis surgery in children with cerebral palsy Type de document : texte imprimé Auteurs : Elke Vandendriessche ; Marijke Proesmans ; Els Ortibus ; Pierre Moens Année de publication : 2021 Article en page(s) : p. 255-261 Note générale : https://doi.org/10.52628/87.2.08 Langues : Anglais (eng) Mots-clés : cerebral palsy  scoliosis surgery  complication rate Résumé : Scoliosis is an important problem in children with cerebral palsy (CP). However, the choice for a spinal fusion has to be weighed against the risks of major surgery in this vulnerable population. Paediatricians are frequently consulted preoperatively to assess the (respiratory) risk involved, but data on this question specific for CP are rare. Therefore, we investigated the complication rate after scoliosis surgery in children with CP, compared to idiopathic scoliosis (IS), and we searched for risk factors for the most common complications. In a retrospective monocenter study we analyzed the medical records from all children with CP and IS undergoing scoliosis surgery from 2010 until 2014. Duration of hospitalization and postoperative complications were compared within a 6-month follow-up. Univariate and multivariate logistic regression models were used to identify risk factors. The study included 44 patients with CP (mean age 15y0mo) and 78 patients with IS (mean age 14y6mo). Children with CP experience a higher rate of complications : respiratory and cardiovascular, as well as wound infections and decubitus ulcers (p<0.05). Postoperative pneumonia was the most frequent complication in both patient groups (43% and 18% in CP and IS respectively), with epilepsy being a significant risk factor (OR 3.85, p= 0.037) in children with CP. Intensive care unit and total hospital stay were longer in the CP group (p<0.001). These results may add information on perioperative care and surgical decision making. Permalink : ./index.php?lvl=notice_display&id=96628 [article] Complication rate after scoliosis surgery in children with cerebral palsy [texte imprimé] / Elke Vandendriessche ; Marijke Proesmans ; Els Ortibus ; Pierre Moens . - 2021 . - p. 255-261. https://doi.org/10.52628/87.2.08 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/2 (Juin 2021) . - p. 255-261 Mots-clés : cerebral palsy  scoliosis surgery  complication rate Résumé : Scoliosis is an important problem in children with cerebral palsy (CP). However, the choice for a spinal fusion has to be weighed against the risks of major surgery in this vulnerable population. Paediatricians are frequently consulted preoperatively to assess the (respiratory) risk involved, but data on this question specific for CP are rare. Therefore, we investigated the complication rate after scoliosis surgery in children with CP, compared to idiopathic scoliosis (IS), and we searched for risk factors for the most common complications. In a retrospective monocenter study we analyzed the medical records from all children with CP and IS undergoing scoliosis surgery from 2010 until 2014. Duration of hospitalization and postoperative complications were compared within a 6-month follow-up. Univariate and multivariate logistic regression models were used to identify risk factors. The study included 44 patients with CP (mean age 15y0mo) and 78 patients with IS (mean age 14y6mo). Children with CP experience a higher rate of complications : respiratory and cardiovascular, as well as wound infections and decubitus ulcers (p<0.05). Postoperative pneumonia was the most frequent complication in both patient groups (43% and 18% in CP and IS respectively), with epilepsy being a significant risk factor (OR 3.85, p= 0.037) in children with CP. Intensive care unit and total hospital stay were longer in the CP group (p<0.001). These results may add information on perioperative care and surgical decision making. Permalink : ./index.php?lvl=notice_display&id=96628

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Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study / Thibault Dewilde in Acta Orthopaedica Belgica, Vol.87/1 (Mars 2021)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 175-179 Titre : Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study Type de document : texte imprimé Auteurs : Thibault Dewilde ; Sebastiaan Schelfaut ; Sven Bamps ; Matthias Papen ; Pierre Moens Année de publication : 2021 Article en page(s) : p. 175-179 Note générale : https://doi.org/10.52628/87.1.22 Langues : Anglais (eng) Mots-clés : scoliosis  coronal balance  intraoperative assesment  coronal alignement  scoliosis surgery Résumé : Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Permalink : ./index.php?lvl=notice_display&id=96602 [article] Intra operative assessment of the coronal balance in spinal deformity surgery : a technical note and retrospective study [texte imprimé] / Thibault Dewilde ; Sebastiaan Schelfaut ; Sven Bamps ; Matthias Papen ; Pierre Moens . - 2021 . - p. 175-179. https://doi.org/10.52628/87.1.22 Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.87/1 (Mars 2021) . - p. 175-179 Mots-clés : scoliosis  coronal balance  intraoperative assesment  coronal alignement  scoliosis surgery Résumé : Obtaining a spine that is well balanced after fusion for scoliotic deformity is primordial for the patients’ quality of life. A simple T-shaped instrument combined with standard intraoperative fluoroscopy can be of great help to evaluate the coronal alignment quickly. The aim of this study was to evaluate if a T-shaped device could predict the postoperative coronal balance. Before finalization of the rod fixation, the balance was checked by verifying the relationship between the T-shaped instrument and the upper instrumented vertebra (UIV), and final adjustments were made to correct the coronal balance. A retrospective study was conducted on 48 patients who underwent surgery to correct scoliotic deformity. Intraoperative and postoperative coronal alignment was measured independently by two observers. The mean intraoperative horizontal offset measured between T-shaped instrument and the center of the UIV was 1,69mm to the right with a standard deviation (SD) of 12,43 mm. On postoperative full spine radiographs, the mean offset between the centra sacral vertical line and the center of the UIV was 2,44mm to the left with a SD of 13,10mm. There is no significant difference in coronal balance between both measurements (p=0,12). With this technique we were able to predict the postoperative coronal balance in all but one patient (97,92%). We conclude that the use of a simple T-shaped instrument can provide adequate intraoperative assessment of coronal balance in correcting scoliotic deformity. Permalink : ./index.php?lvl=notice_display&id=96602

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