63.
Prevalence of complications in neuromuscular scoliosis surgery: A
literature meta-analysis from the past 15 years
Shallu SHARMA, Cody Eric BUNGER, Thomas ANDERSEN, Ebbe Stender
HANSEN
Department of Orthopedics,E Aarhus University Hospital, Noerrebrogade 44;
Department of Orthopedics,E, Aarhus University Hospital, Noerrebrogade 44;
Department of Orthopedics,E, Aarhus University Hospital, Noerrebrogade 44;
Department of Orthopedics,E, Aarhus University Hospital, Noerrebrogade 44
Background:
Neuromuscular scoliosis amplifies the complexity of surgical
intervention. While scoliosis surgery promises improvement in function,
cosmesis, and overall quality of life, it is also affiliated with high risk of peri-
and postoperative complications. This raises concerns about the certainty of
benefits of scoliosis surgery. For a better understanding of complexities in
benefit vs. complications, a meta- analytic of complications literature was
performed.
Purpose / Aim of Study:
To review the published literature on complications
in neuromuscular scoliosis (NMS) surgery and, to determine the overall pooled
rates (PR) of various complications associated with NMS surgery by a meta-
analysis
Materials and Methods:
PubMed and Embase databases were searched for
publications (1997 -May 2011) reporting the outcomes and complications of
NMS surgery. PR’s were measured using a random effects meta-analytic
model.
Findings / Results:
Systematic review and Meta-analysis was performed for
68
studies and 5218 NMS patients. Pulmonary complications were the most
reported (PR=22.71%) followed by implant complications (PR=12.51%),
infections and neurological complications. Revision, removal and extension of
implant had highest PR (7.87%) followed by malplacement of pedicle screws
(4.81%).
Sensitivity analysis( age at surgery, publication year and diagnosis)
partly explain the variability in PR’s. In regard to surgical complications with
various surgical techniques in NMS, the level of evidence ranges between 2+
to 2-; the subsequent recommendations are level C
Conclusions:
High PR’s warrant attention from the surgical community.
Although the PR of all complications are affected by heterogeneity, they
nevertheless provide valuable insights on the impact methodological settings,
patient characteristics, and advances in patient care have on complication rates.
