1559. Effect of Postoperative Spinopelvic Parameters on Outcomes of Pediatric Patients Surgically Treated for Neuromuscular Scoliosis
Authors: Kathryn Hoes, MD; Dillon Mobasser, BS; Piiamaria Virtanen, BS; Nucharin Supakal, MD; Andrew Jea (Indianapolis, IN)
The objective of this study was determining the influence of postoperative sagittal spinopelvic alignment on reported outcome measures following neuromuscular scoliosis surgery.
The authors retrospectively reviewed a series of 13 patients who underwent surgery for neuromuscular scoliosis between January 1, 2017 and April 20, 2018. The mean follow up was 7.5 months (range, 1 – 16 months). Surgery was performed to prevent progressive spinal deformity, and not necessarily intended to correct global sagittal alignment. Sagittal alignment was only assessed postoperatively. Patients were divided into 2 groups: postoperative sagittal vertical axis (SVA) < 50 mm (well-balanced) and SVA ≥ 50 mm (poorly-balanced). Demographic, procedural, and outcome data were compared between groups. Postoperative outcome measures and spinopelvic parameters were compared between groups using Wilcoxon Rank Sum and Fisher’s Exact tests.
Of the 13 patients included in this study, 38.5% had an SVA < 50 mm. BMI < 25 (p value 0.421) was more common among patients in the well-balanced group. All patients were either GMFCS 4 or 5. GMFCS 5 was more common in the well-balanced group and GMFCS 4 was more common in the poorly-balanced group (p value 0.081). Fusions from Cervical-Sacrum relative to Thoracic-Sacrum fusions were more common in the well-balanced group (p value 0.641). Patients with an SVA ≥ 50 mm have no difference in Parent, Patient or mean PedsQL scores (p values 0.551, 0.105, 0.391 respectively). The means in mm for spinopelvic parameters differing between the well- and poorly-balanced groups respectively included LL (46.4 vs. 47.1; p value 0.769), PI (39.9 vs. 49.5; p value 0.213), PT (17.8 vs. 17.4; p value 0.942), and SS (24.6 vs. 30.1; p value 0.510).
Our data shows that patient- (or parent-) reported outcome is not influenced by the overall postoperative sagittal balance as represented by SVA.