Clinical relevance of echocardiogram in patients with cerebral palsy undergoing posterior spinal fusion

2015 ◽  
Vol 25 (8) ◽  
pp. 840-845 ◽  
Author(s):  
Sabina DiCindio ◽  
Lynda Arai ◽  
Michael McCulloch ◽  
Kesavan Sadacharam ◽  
Suken A. Shah ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Spinal Fusion ◽  
Clinical Relevance ◽  
Posterior Spinal Fusion

scholarly journals Releasing the tether: Weight normalization following corrective spinal fusion in cerebral palsy

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901878255 ◽  
Author(s):  
Christopher J DeFrancesco ◽  
Daniel J Miller ◽  
Patrick J Cahill ◽  
David A Spiegel ◽  
John M Flynn ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cerebral Palsy ◽  
Weight Gain ◽  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Abdominal Pressure ◽  
Level Of Evidence ◽  
Feeding Difficulties ◽  
Weight Percentile

Purpose: Feeding difficulties are common among patients with cerebral palsy (CP) and neuromuscular (NM) scoliosis. We theorize that posterior spinal fusion (PSF) reduces intra-abdominal pressure, resulting in improved feeding and subsequent weight gain. We hypothesized that, among nonambulatory patients with CP and NM scoliosis, we would observe significant gain in weight following PSF. Methods: Fifty subjects with nonambulatory CP who underwent PSF for NM scoliosis were included. Age and weight were recorded for the preoperative year; on the day of surgery; and at 6-month, 1-year, and 2-year follow-up. Weights were converted to weight percentiles using CP-specific growth charts. The weight percentile distributions were compared between time points using descriptive statistics as well as regression analysis. Results: The average change in weight from the day of surgery to 2-year follow-up was +3.4 percentiles. Patients who started out under the 50th percentile gained an average of 17.3 percentiles in the first year after PSF ( p = 0.009). Regression analysis showed that patients with baseline weight <50th percentile tended to gain in weight percentile over the first postoperative year ( β = 1.990, p = 0.001). No trend was present among this group prior to surgery ( p = 0.692) or during the second postoperative year ( p = 0.945). No trends were noted prior to or after surgery for patients with baseline weights ≥50th percentile. No significant association was observed between curve severity (measured by preoperative Cobb angle) and weight change. Conclusions: This series is the first to document significant weight gain after PSF for NM scoliosis, supporting the theory that spinal correction improves digestive function. Level of Evidence: Prognostic level II.

scholarly journals Hospital Burdens of Patients With Cerebral Palsy Undergoing Posterior Spinal Fusion for Scoliosis

2020 ◽  
pp. 219256822096854
Author(s):  
Albert T. Anastasio ◽  
Ndeye F. Guisse ◽  
Kevin X. Farley ◽  
John M. Rhee
Keyword(s):  
Cerebral Palsy ◽  
Spinal Fusion ◽  
Hospital Costs ◽  
Posterior Spinal Fusion ◽  
Complication Rates ◽  
Total Hospital ◽  
Treatment Protocols ◽  
Patient Demographics ◽  
Discharge Status ◽  
Complications And Mortality

Study Design: Retrospective cohort study. Objectives: Many patients undergoing posterior spinal fusion (PSF) for scoliosis have concurrent cerebral palsy (CP), which is associated with many medical comorbidities and inherent operative risk. We aimed to quantify the contribution of CP to increased cost, length of stay (LOS), and complication rates in patients with scoliosis undergoing PSF. Methods: Using the National Inpatient Sample database, we collected data regarding patient demographics, hospital characteristics, comorbidities, in-hospital complications, and mortality. Primary outcomes included complications, hospital LOS, and total hospital costs. Multivariate regression models assessed the contribution of CP to in-hospital complications, discharge status, and mortality. Linear regression identified the contribution of a diagnosis of CP on hospital LOS and inflation-adjusted cost. Results: Cerebral palsy was an independent predictor of several complications. The most striking differences were seen for mortality (odds ratio [OR]: 3.40, P < .001), a postoperative requirement for total parenteral nutrition (OR: 3.16, P < .001), urinary tract infection (OR: 2.75, P < .001), surgical site infection (OR: 2.67, P < .001), and pneumonia (2.21, P < .001). Patients with CP ultimately cost an additional $13 482 ( P < .001) with a 2.07-day greater LOS ( P < .001) than patients without CP. Conclusion: Most complications were seen in higher rates in the CP cohort, with higher cost and LOS in patients with CP versus those with idiopathic scoliosis (IS). Our findings represent important areas of emphasis during preoperative consultations with patients with CP and their families. Extra care in patient selection and multifaceted treatment protocols should continue to be implemented with further investigation on how to mitigate common complications.

The Role of Cross-Links in Posterior Spinal Fusion for Cerebral Palsy–Related Scoliosis

Spine ◽  
2019 ◽  
Vol 44 (21) ◽  
pp. E1256-E1263
Author(s):  
M. Farooq Usmani ◽  
Suken A. Shah ◽  
Burt Yaszay ◽  
Amer F. Samdani ◽  
Patrick J. Cahill ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Cross Links
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