%0 Journal Article %1 Tsirikos2003a %A Tsirikos, Athanasios I %A Chang, Wei-Ning %A Dabney, K. W. %A Miller, Freeman %D 2003 %J Spine %K Adolescent; Adult; Cerebral Palsy; Child; Female; Humans; Intraoperative Complications; Male; Neuromuscular Diseases; Orthopedic Fixation Devices; Postoperative Quadriplegia; Retrospective Studies; Scoliosis; Spinal Fusion; Treatment Outcome %N 12 %P 1300--1305 %R 10.1097/01.BRS.0000065572.10824.AB %T Comparison of one-stage versus two-stage anteroposterior spinal fusion in pediatric patients with cerebral palsy and neuromuscular scoliosis. %U http://dx.doi.org/10.1097/01.BRS.0000065572.10824.AB %V 28 %X STUDY DESIGN: A retrospective study was performed including 45 pediatric patients with spastic quadriplegic cerebral palsy and neuromuscular scoliosis who underwent anteroposterior spinal fusion. OBJECTIVES: To evaluate the outcomes and complications of one-stage and two-stage combined anteroposterior spine fusion and to document which procedure is more efficacious and provides better results. SUMMARY OF BACKGROUND DATA: Circumferential spinal arthrodesis has been proven to achieve better scoliotic curve correction, decreasing significantly the risk of pseudarthrosis and progression of the deformity. There have been a few studies comparing same-day versus staged anteroposterior spinal surgery in mixed populations with neuromuscular scoliosis, but not in an isolated group of pediatric patients with spastic cerebral palsy. METHODS: The medical records and radiographs of all patients were reviewed, and the results were statistically analyzed. The complications were divided into medical, subcategorized into major and minor, and technical. RESULTS: There was no statistically significant difference (P > 0.05) between one-stage (Group 1) and two-stage (Group 2) patients, considering age at surgery, preoperative scoliosis angle, pelvic obliquity, kyphosis angle, lordosis angle, levels of anterior release, percentage of scoliosis correction, radiographic follow-up, hospitalization time, and intensive care unit stay. Sequentially performed spinal procedures (Group 1) were associated with increased intraoperative blood loss, prolonged operative time, and a considerably higher incidence of medical and technical complications, including two perioperative deaths. CONCLUSION: Two-stage anteroposterior spinal fusion provides safer and more consistent results with several advantages over the single-stage procedure in the management of patients with cerebral palsy and neuromuscular scoliosis.

@article{Tsirikos2003a, abstract = {STUDY DESIGN: A retrospective study was performed including 45 pediatric patients with spastic quadriplegic cerebral palsy and neuromuscular scoliosis who underwent anteroposterior spinal fusion. OBJECTIVES: To evaluate the outcomes and complications of one-stage and two-stage combined anteroposterior spine fusion and to document which procedure is more efficacious and provides better results. SUMMARY OF BACKGROUND DATA: Circumferential spinal arthrodesis has been proven to achieve better scoliotic curve correction, decreasing significantly the risk of pseudarthrosis and progression of the deformity. There have been a few studies comparing same-day versus staged anteroposterior spinal surgery in mixed populations with neuromuscular scoliosis, but not in an isolated group of pediatric patients with spastic cerebral palsy. METHODS: The medical records and radiographs of all patients were reviewed, and the results were statistically analyzed. The complications were divided into medical, subcategorized into major and minor, and technical. RESULTS: There was no statistically significant difference (P > 0.05) between one-stage (Group 1) and two-stage (Group 2) patients, considering age at surgery, preoperative scoliosis angle, pelvic obliquity, kyphosis angle, lordosis angle, levels of anterior release, percentage of scoliosis correction, radiographic follow-up, hospitalization time, and intensive care unit stay. Sequentially performed spinal procedures (Group 1) were associated with increased intraoperative blood loss, prolonged operative time, and a considerably higher incidence of medical and technical complications, including two perioperative deaths. CONCLUSION: Two-stage anteroposterior spinal fusion provides safer and more consistent results with several advantages over the single-stage procedure in the management of patients with cerebral palsy and neuromuscular scoliosis.}, added-at = {2014-07-19T21:49:45.000+0200}, author = {Tsirikos, Athanasios I and Chang, Wei-Ning and Dabney, K. W. and Miller, Freeman}, biburl = {https://www.bibsonomy.org/bibtex/207d03dcb972f9066a6a4b7ba4a520b4b/ar0berts}, doi = {10.1097/01.BRS.0000065572.10824.AB}, groups = {public}, interhash = {bb361aa91de970fb710740e067938a6f}, intrahash = {07d03dcb972f9066a6a4b7ba4a520b4b}, journal = {Spine}, keywords = {Adolescent; Adult; Cerebral Palsy; Child; Female; Humans; Intraoperative Complications; Male; Neuromuscular Diseases; Orthopedic Fixation Devices; Postoperative Quadriplegia; Retrospective Studies; Scoliosis; Spinal Fusion; Treatment Outcome}, month = Jun, number = 12, pages = {1300--1305}, pmid = {12811275}, timestamp = {2014-07-19T21:49:45.000+0200}, title = {Comparison of one-stage versus two-stage anteroposterior spinal fusion in pediatric patients with cerebral palsy and neuromuscular scoliosis.}, url = {http://dx.doi.org/10.1097/01.BRS.0000065572.10824.AB}, username = {ar0berts}, volume = 28, year = 2003 }