Scoliosis surgery in cerebral palsy: Differences between unit rod and custom rods

Paul D. Sponseller, Suken A. Shah, Mark F. Abel, Daniel Sucato, Peter O. Newton, Harry Shufflebarger, Lawrence G. Lenke, Lynn Letko, Randal Betz, Michelle Marks, Tracey Bastrom

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

STUDY DESIGN.: Retrospective review. OBJECTIVE.: To evaluate the differences in intraoperative factors and postoperative results between pediatric patients with cerebral palsy (CP) treated with unit rods and those treated with custom-bent rods. SUMMARY OF BACKGROUND DATA.: No prior study has directly compared unit and custom-bent rods for CP. METHODS.: We retrospectively analyzed the clinical and radiographic data of 157 children with CP who underwent posterior spinal fusion. Of those 157, we treated 79 with unit rods and 78 with custom-bent rods. Minimum follow-up was 2 years. RESULTS.: Intraoperatively, unit rod surgeries were associated with significantly shorter mean surgical time (339 and 379 minutes, respectively; P = 0.04), longer mean intensive care unit stay (4 vs. 3 days, respectively; P = 0.001), and longer mean hospital stay (14 vs. 13 days; P = 0.006) than custom-bent rod procedures. The mean estimated blood loss was higher for unit rods (2124 vs. 1885 mL, respectively), but not significantly so. After surgery, unit rod surgeries were associated with significantly more mean pelvic obliquity correction (74% vs. 22%, respectively; P = 0.002), more mean clinically apparent implant prominence at 2-year follow-up (12 vs. 2 instances; P = 0.03; most were proximal), and a higher mean infection rate (15% vs. 5%, respectively; P = 0.03). There were no significant differences in final major Cobb correction, curves with an apex above or below T10, implant-related reoperations, or neurologic complications. The only factor that was statistically correlated with the overall complication rate for both groups was absolute curve magnitude (P = 0.04). CONCLUSION.: Compared with custom-bent rods, unit rods provided superior correction of pelvic obliquity but were associated with higher transfusion requirements, higher infection rates, more proximal fixation problems, and longer intensive care unit and hospital stays.

Original languageEnglish (US)
Pages (from-to)840-844
Number of pages5
JournalSpine
Volume34
Issue number8
DOIs
StatePublished - Apr 15 2009

Fingerprint

Scoliosis
Cerebral Palsy
Intensive Care Units
Length of Stay
Spinal Fusion
Operative Time
Infection
Reoperation
Nervous System
Pediatrics

Keywords

  • Cerebral palsy
  • Fusion
  • Pelvic obliquity
  • Scoliosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Sponseller, P. D., Shah, S. A., Abel, M. F., Sucato, D., Newton, P. O., Shufflebarger, H., ... Bastrom, T. (2009). Scoliosis surgery in cerebral palsy: Differences between unit rod and custom rods. Spine, 34(8), 840-844. https://doi.org/10.1097/BRS.0b013e31819487b7

Scoliosis surgery in cerebral palsy : Differences between unit rod and custom rods. / Sponseller, Paul D.; Shah, Suken A.; Abel, Mark F.; Sucato, Daniel; Newton, Peter O.; Shufflebarger, Harry; Lenke, Lawrence G.; Letko, Lynn; Betz, Randal; Marks, Michelle; Bastrom, Tracey.

In: Spine, Vol. 34, No. 8, 15.04.2009, p. 840-844.

Research output: Contribution to journalArticle

Sponseller, PD, Shah, SA, Abel, MF, Sucato, D, Newton, PO, Shufflebarger, H, Lenke, LG, Letko, L, Betz, R, Marks, M & Bastrom, T 2009, 'Scoliosis surgery in cerebral palsy: Differences between unit rod and custom rods', Spine, vol. 34, no. 8, pp. 840-844. https://doi.org/10.1097/BRS.0b013e31819487b7
Sponseller PD, Shah SA, Abel MF, Sucato D, Newton PO, Shufflebarger H et al. Scoliosis surgery in cerebral palsy: Differences between unit rod and custom rods. Spine. 2009 Apr 15;34(8):840-844. https://doi.org/10.1097/BRS.0b013e31819487b7
Sponseller, Paul D. ; Shah, Suken A. ; Abel, Mark F. ; Sucato, Daniel ; Newton, Peter O. ; Shufflebarger, Harry ; Lenke, Lawrence G. ; Letko, Lynn ; Betz, Randal ; Marks, Michelle ; Bastrom, Tracey. / Scoliosis surgery in cerebral palsy : Differences between unit rod and custom rods. In: Spine. 2009 ; Vol. 34, No. 8. pp. 840-844.
@article{f090ee81483d435eb958d69fce1c44f6,
title = "Scoliosis surgery in cerebral palsy: Differences between unit rod and custom rods",
abstract = "STUDY DESIGN.: Retrospective review. OBJECTIVE.: To evaluate the differences in intraoperative factors and postoperative results between pediatric patients with cerebral palsy (CP) treated with unit rods and those treated with custom-bent rods. SUMMARY OF BACKGROUND DATA.: No prior study has directly compared unit and custom-bent rods for CP. METHODS.: We retrospectively analyzed the clinical and radiographic data of 157 children with CP who underwent posterior spinal fusion. Of those 157, we treated 79 with unit rods and 78 with custom-bent rods. Minimum follow-up was 2 years. RESULTS.: Intraoperatively, unit rod surgeries were associated with significantly shorter mean surgical time (339 and 379 minutes, respectively; P = 0.04), longer mean intensive care unit stay (4 vs. 3 days, respectively; P = 0.001), and longer mean hospital stay (14 vs. 13 days; P = 0.006) than custom-bent rod procedures. The mean estimated blood loss was higher for unit rods (2124 vs. 1885 mL, respectively), but not significantly so. After surgery, unit rod surgeries were associated with significantly more mean pelvic obliquity correction (74{\%} vs. 22{\%}, respectively; P = 0.002), more mean clinically apparent implant prominence at 2-year follow-up (12 vs. 2 instances; P = 0.03; most were proximal), and a higher mean infection rate (15{\%} vs. 5{\%}, respectively; P = 0.03). There were no significant differences in final major Cobb correction, curves with an apex above or below T10, implant-related reoperations, or neurologic complications. The only factor that was statistically correlated with the overall complication rate for both groups was absolute curve magnitude (P = 0.04). CONCLUSION.: Compared with custom-bent rods, unit rods provided superior correction of pelvic obliquity but were associated with higher transfusion requirements, higher infection rates, more proximal fixation problems, and longer intensive care unit and hospital stays.",
keywords = "Cerebral palsy, Fusion, Pelvic obliquity, Scoliosis",
author = "Sponseller, {Paul D.} and Shah, {Suken A.} and Abel, {Mark F.} and Daniel Sucato and Newton, {Peter O.} and Harry Shufflebarger and Lenke, {Lawrence G.} and Lynn Letko and Randal Betz and Michelle Marks and Tracey Bastrom",
year = "2009",
month = "4",
day = "15",
doi = "10.1097/BRS.0b013e31819487b7",
language = "English (US)",
volume = "34",
pages = "840--844",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Scoliosis surgery in cerebral palsy

T2 - Differences between unit rod and custom rods

AU - Sponseller, Paul D.

AU - Shah, Suken A.

AU - Abel, Mark F.

AU - Sucato, Daniel

AU - Newton, Peter O.

AU - Shufflebarger, Harry

AU - Lenke, Lawrence G.

AU - Letko, Lynn

AU - Betz, Randal

AU - Marks, Michelle

AU - Bastrom, Tracey

PY - 2009/4/15

Y1 - 2009/4/15

N2 - STUDY DESIGN.: Retrospective review. OBJECTIVE.: To evaluate the differences in intraoperative factors and postoperative results between pediatric patients with cerebral palsy (CP) treated with unit rods and those treated with custom-bent rods. SUMMARY OF BACKGROUND DATA.: No prior study has directly compared unit and custom-bent rods for CP. METHODS.: We retrospectively analyzed the clinical and radiographic data of 157 children with CP who underwent posterior spinal fusion. Of those 157, we treated 79 with unit rods and 78 with custom-bent rods. Minimum follow-up was 2 years. RESULTS.: Intraoperatively, unit rod surgeries were associated with significantly shorter mean surgical time (339 and 379 minutes, respectively; P = 0.04), longer mean intensive care unit stay (4 vs. 3 days, respectively; P = 0.001), and longer mean hospital stay (14 vs. 13 days; P = 0.006) than custom-bent rod procedures. The mean estimated blood loss was higher for unit rods (2124 vs. 1885 mL, respectively), but not significantly so. After surgery, unit rod surgeries were associated with significantly more mean pelvic obliquity correction (74% vs. 22%, respectively; P = 0.002), more mean clinically apparent implant prominence at 2-year follow-up (12 vs. 2 instances; P = 0.03; most were proximal), and a higher mean infection rate (15% vs. 5%, respectively; P = 0.03). There were no significant differences in final major Cobb correction, curves with an apex above or below T10, implant-related reoperations, or neurologic complications. The only factor that was statistically correlated with the overall complication rate for both groups was absolute curve magnitude (P = 0.04). CONCLUSION.: Compared with custom-bent rods, unit rods provided superior correction of pelvic obliquity but were associated with higher transfusion requirements, higher infection rates, more proximal fixation problems, and longer intensive care unit and hospital stays.

AB - STUDY DESIGN.: Retrospective review. OBJECTIVE.: To evaluate the differences in intraoperative factors and postoperative results between pediatric patients with cerebral palsy (CP) treated with unit rods and those treated with custom-bent rods. SUMMARY OF BACKGROUND DATA.: No prior study has directly compared unit and custom-bent rods for CP. METHODS.: We retrospectively analyzed the clinical and radiographic data of 157 children with CP who underwent posterior spinal fusion. Of those 157, we treated 79 with unit rods and 78 with custom-bent rods. Minimum follow-up was 2 years. RESULTS.: Intraoperatively, unit rod surgeries were associated with significantly shorter mean surgical time (339 and 379 minutes, respectively; P = 0.04), longer mean intensive care unit stay (4 vs. 3 days, respectively; P = 0.001), and longer mean hospital stay (14 vs. 13 days; P = 0.006) than custom-bent rod procedures. The mean estimated blood loss was higher for unit rods (2124 vs. 1885 mL, respectively), but not significantly so. After surgery, unit rod surgeries were associated with significantly more mean pelvic obliquity correction (74% vs. 22%, respectively; P = 0.002), more mean clinically apparent implant prominence at 2-year follow-up (12 vs. 2 instances; P = 0.03; most were proximal), and a higher mean infection rate (15% vs. 5%, respectively; P = 0.03). There were no significant differences in final major Cobb correction, curves with an apex above or below T10, implant-related reoperations, or neurologic complications. The only factor that was statistically correlated with the overall complication rate for both groups was absolute curve magnitude (P = 0.04). CONCLUSION.: Compared with custom-bent rods, unit rods provided superior correction of pelvic obliquity but were associated with higher transfusion requirements, higher infection rates, more proximal fixation problems, and longer intensive care unit and hospital stays.

KW - Cerebral palsy

KW - Fusion

KW - Pelvic obliquity

KW - Scoliosis

UR - http://www.scopus.com/inward/record.url?scp=67650477114&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650477114&partnerID=8YFLogxK

U2 - 10.1097/BRS.0b013e31819487b7

DO - 10.1097/BRS.0b013e31819487b7

M3 - Article

C2 - 19365254

AN - SCOPUS:67650477114

VL - 34

SP - 840

EP - 844

JO - Spine

JF - Spine

SN - 0362-2436

IS - 8

ER -