COMPLICATIONS IN PEDIATRIC NEUROMUSCULAR SPINAL DEFORMITY SURGERY: A COHORT STUDY OF 45 PATIENTS AND RISK FACTOR ANALYSIS
Journal of Turkish Spinal Surgery, cilt.36, sa.3, ss.137-143, 2025 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 36 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.4274/jtss.galenos.2025.51423
- Dergi Adı: Journal of Turkish Spinal Surgery
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.137-143
- Anahtar Kelimeler: Neuromuscular spinal deformity, pediatric spine surgery, posterior spinal fusion, risk factors, surgical complications
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Neuromuscular spinal deformity (NMSD) is a complex, progressive condition that affects children with disorders such as cerebral palsy, muscular dystrophy and spinal muscular atrophy. These children often experience significant functional limitations and an increased risk of surgery. This study aims to classify intraoperative and postoperative complications in pediatric NMSD surgery and identify related risk factors. Materials and Methods: We retrospectively reviewed 45 pediatric patients who underwent surgical correction for NMSD between June 2020 and December 2024. We collected demographic, clinical, and surgical data. Complications were categorised as either intraoperative or postoperative. Logistic regression analysis was performed to identify risk factors associated with complications. Results: Of the 45 patients (53% female; mean age: 11.7 years), 13 underwent growth-friendly procedures and 32 underwent definitive posterior spinal fusion. Intraoperative complications occurred in 37.8% of cases, primarily due to excessive bleeding (n=14). Postoperative complications were observed in 55.6% of patients, with the most frequent being infections (n=16), respiratory issues (n=12), and implant problems (n=9). The presence of a ventriculoperitoneal shunt, a history of previous spinal surgery, non-ambulatory status, pelvic fixation, and longer operative times were all significantly associated with higher complication rates. Conclusion: Children with NMSD are at considerable risk during and after spinal surgery due to their underlying health conditions. Our findings emphasise the importance of recognising risk factors early on to improve outcomes. While surgical correction can offer substantial functional and postural advantages, a personalised, multidisciplinary care approach is essential to minimise complications and facilitate recovery in this vulnerable group.