Predictors of postoperative complications after selective dorsal rhizotomy.

Acta neurochirurgica
Johannes WachHannes Haberl

Abstract

Selective dorsal rhizotomy (SDR) reduces spasticity in children with cerebral palsy (CP). We analyzed potential preoperative predictors of complications after SDR via single-level laminectomy at the conus medullaris. One hundred and forty SDRs performed in children (2-17 years) with CP were included in this retrospective study (March 2016 to July 2019). Of these children, 69% were ambulatory (Gross Motor Functional Classification System (GMFCS) II and III). Variables associated with wound dehiscence and infections, cerebrospinal fluid (CSF) leaks, and prolonged epidural pain management were analyzed statistically. Five children (3.6%) showed prolonged wound healing, which was associated with obesity (BMI z-score ≥ 1.64; odds ratio (OR) 24.4; 95% confidence interval (CI) 3-199; p = 0.003). Two cases (1.4%) had superficial surgical site infections (SSIs), which was associated with obesity (p = 0.004) and thrombocytopenia (< 180,000 G/l; p = 0.028). The area under the curve at ≥ 1.55 BMI z-score for SSI was 0.97 (95% CI 0.93-0.99, p = 0.024), with a sensitivity and specificity for SSI of 100 and 94.9%, respectively. CSF leaks occurred in four (2.9%) children, associated with age ≤ 5 years (p = 0.029). Fifteen (10.7%) children requ...Continue Reading

References

Jul 1, 1992·Statistics in Medicine·T J Cole, P J Green
Jun 8, 1989·The New England Journal of Medicine·R R Young
May 21, 1998·Developmental Medicine and Child Neurology·J F McLaughlinN Temkin
Apr 29, 1999·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·A J MangramW R Jarvis
Jan 29, 2002·Developmental Medicine and Child Neurology·John McLaughlinAnne Ferrel
Mar 29, 2002·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·G Sheean
Feb 11, 2005·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Petra E M van SchieJules G Becher
May 13, 2006·Journal of Thrombosis and Haemostasis : JTH·N LaurensM P M de Maat
Sep 12, 2006·Journal of Neurosurgery. Spine·Anthony H SinAnil Nanda
Feb 17, 1898·The Journal of Physiology·C S Sherrington
Jun 17, 2008·Pediatric Neurology·Sophelia Hoi-Shan ChanWai Kwong Chak
Dec 17, 2008·BMC Pediatrics·Eva NordmarkLena Westbom
Mar 14, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Brian T JankowitzWilliam C Welch
Oct 5, 2010·Journal of Neurosurgery. Pediatrics·Bruce A KaufmanSean M Lew
Dec 17, 2011·The Spine Journal : Official Journal of the North American Spine Society·Jae-Young HongJoonsung Byun
Sep 10, 2013·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Victor LiuPaul Steinbok
Jan 5, 2014·PloS One·Maria Chiara BarsottiGiorgio Soldani
Dec 4, 2014·Blood Reviews·Ewelina M Golebiewska, Alastair W Poole
Feb 12, 2015·Archives of Disease in Childhood·Kristian AquilinaNeil Wimalasundera
May 1, 2015·Brazilian Journal of Anesthesiology·Débora Miranda Diogo StabilleMiguel Tanús Jorge
Jan 14, 2016·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Julia Franziska Funk, Hannes Haberl
Feb 18, 2016·Acta Paediatrica·Ann Alriksson-Schmidt, Gunnar Hägglund
May 6, 2016·Journal of Paediatrics and Child Health·Jessica PascoeMatthew A Sabin
Dec 24, 2016·Surgical Infections·Brian P BlackwoodCatherine J Hunter
Mar 8, 2018·Developmental Medicine and Child Neurology·Ibrahim DuranEckhard Schoenau
Jun 12, 2018·Clinical Spine Surgery : a Spine Publication·Morgan R KohlsSafdar N Khan
May 3, 2019·The Lancet Child & Adolescent Health·Jennifer SummersUNKNOWN Selective Dorsal Rhizotomy Steering Committee

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