Medical Student University of Wisconsin School of Medicine and Public Health New Berlin, Wisconsin, United States
Introduction: Congenital scoliosis is a potentially debilitating condition that affects pediatric patients and frequently requires surgical correction. In the past 10 years a transition from an anterior spinal fusion (ASF) and combined spinal fusion (CSF) approach to a posterior spinal fusion (PSF) approach has occurred. Studies on the impact of this change in operative technique using a large dataset has been investigated in a similar condition, idiopathic scoliosis, but has yet to be investigated in congenital scoliosis. To understand trends in congenital scoliosis patients undergoing spinal fusions between 1997 to 2016, as well as investigation into demographics such as age, length of stay (LOS), and surgical procedure type.
Methods: The Kids’ Inpatient Database (KID) was queried from 1997-2016 using ICD 9 and 10 codes for congenital scoliosis patients (ICD-9 754.2; ICD-10 Q763 and W675) and ICD 9/10 procedural codes for anterior, posterior, and combined spinal fusions. Predictors of mortality and inpatient complications was done using multivariate logistic analysis. Trends in utilization were analyzed using multivariate linear regressions.
Results: A total of 2,890 congenital scoliosis patients age 0-18 undergoing spinal fusion were found. Rate of any medical complication was lower in PSF at 33.9% compared to ASF at 38.62% and CSF at 40.14%. There was no increased risk of mortality between spinal fusion procedures. The rate of respiratory complications, infections, and overall length of stay were all lower in PSF patients.
Conclusion : Utilization PSF in congenital scoliosis patients has increased, while ASF and CSF have decreased between 2003 to 2016. PSF are correlated with a lower risk of medical complication and LOS. This data may be used to help with risk stratification for congenital scoliosis patients requiring surgical correction.
