Complications of Surgical Treatment of Pediatric Spinal Deformities

Surgery in a child with spinal deformity is challenging. Although current orthopedic practice ensures good long-term surgical results, complications occur. Idiopathic scoliosis represents the most extensively investigated deformity of the pediatric spine. Nonidiopathic deformities of the spine are at higher risk for perioperative and long-term complications, mainly because of underlying comorbidities. A multidisciplinary treatment strategy is helpful to assure optimization of medical conditions before surgery. Awareness of complications that occur during or after spine surgery is essential to avoid a poor outcome and for future surgical decision making. This article summarizes the complications of surgical treatment of the growing spine.

Key points

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Although current orthopedic practice ensures good long-term surgical results, complications occur, with reported prevalences of 15.4% and 0.69% for non-neurologic and neurologic complications, respectively.
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Factors associated with increased risk for neurologic injury in adolescent idiopathic scoliosis are categorized as surgeon dependent and surgeon independent.
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Factors that are responsible for, or contribute to, non-neurologic complications in adolescent idiopathic scoliosis surgical management are prolonged anesthesia time, excessive bleeding, and history of renal disease.
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Pediatric patients requiring surgery for nonidiopathic deformities of the spine are at higher risk for perioperative and long-term complications, mainly because of underlying comorbidities.
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In all patients with nonidiopathic deformities of the spine, a multidisciplinary treatment strategy is helpful to assure optimization of medical conditions before surgery.