Abstract
Study design
Retrospective review of a prospective database.
Purpose
To determine the rate of short-term surgical complications in the 3-month postoperative period in patients with myelomeningocele (MMC) who underwent surgical correction of spine deformities.
Methods
This study reviewed the medical records of MMC patients, aged ≤ 18 years, who underwent spine deformity correction between 2012 and 2018. Clinical, radiological, and surgical variables were considered.
Results
Forty-six patients with primary preoperative curve, pelvic obliquity, and kyphosis mean values of 84.9º, 21.5º, and 76.1º, respectively, were included. Thirty-four (74%) patients underwent scoliosis correction and 12 (26%), kyphectomy. A trend in reduction of %EBV (estimated blood volume) loss with antifibrinolytic use from 50.2 ± 32.3 to 33.8 ± 17.2% was observed (p = 0.103). Simultaneous detethering was performed in 13 (27.7%) patients and was not associated with higher short-term complication rates. There were 12 cases of short-term surgical complications (26.1%); among them, six had deep wound infection requiring surgical debridement, and one a superficial wound infection. Drainage time longer than 4 days was significantly associated with wound infection (OR = 15.8, p = 0.01).
Conclusions
The surgical treatment of neuromuscular scoliosis in MMC patients is challenging because of the high comorbidity rate. Still, we found an admissible rate of short-term surgical complications with a multidisciplinary approach in a setting with extensive spine deformity surgery experience.
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Acknowledgements
The authors gratefully acknowledge Mrs. Erika Carvalho Pires Arci for her valuable statistical assistance.
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AOdA, DF, LMRD, RGdO: Made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work. AOdA, CRG, DF, EVMB, LMRD, RGdO: Drafted the work or revised it critically for important intellectual content. AOdA, CRG, DF, EVMB, LMRD, RGdO: Approved the version to be published. AOdA, CRG, DF, EVMB, LMRD, RGdO: Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Research Ethics Committee approval: 08053919.0.0000.0022.
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de Araújo, A.O., Gomes, C.R., Fava, D. et al. Short-term surgical complications of spinal fusion in myelomeningocele. Spine Deform 9, 1151–1159 (2021). https://doi.org/10.1007/s43390-021-00304-8
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DOI: https://doi.org/10.1007/s43390-021-00304-8