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)

Introduction: The objective of this study was determining the influence of postoperative sagittal spinopelvic alignment on reported outcome measures following neuromuscular scoliosis surgery. Methods: 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. Results: 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). Conclusion: Our data shows that patient- (or parent-) reported outcome is not influenced by the overall postoperative sagittal balance as represented by SVA.