P134. Comparing surgical outcomes following scoliosis surgery in Rett Syndrome and cerebral palsy patients

• Published in: The spine journal 2024-09, Vol.24 (9), p.S129-S129
• Main Authors: Sarwahi, Vishal, Hasan, Sayyida, visahan, keshin, Galina, Jesse M, Eigo, Katherine, Rahman, Effat, Boucas, Peter, Gecelter, Rachel, Atlas, Aaron Michael, Goldstein, Jeffrey Alan, Lo, Yungtai, Amaral, Terry D.
• Format: Article
• Language: English
• ISSN: 1529-9430
• DOI: 10.1016/j.spinee.2024.06.156

Rett syndrome (RS) patients commonly develop severe scoliosis that requires treatment to improve their chances of survival. These patients often present with a myriad of challenges and complications during the surgery itself and throughout their recovery including respiratory failure, prolonged intubation, infections, significant blood loss, and prolonged hospital stay. While patients with RS are less common, many surgeons have experience treating Cerebral Palsy (CP) patients. CP patients undergoing scoliosis surgery may be comparable to RS patients. They are often nonverbal and nonambulatory with frequent respiratory and surgical complications. The objective of this study is to compare perioperative outcomes of RS and CP patients. Retrospective chart review. A total of 109 patients with neuromuscular scoliosis (29 Rett Syndrome patients and 80 cerebral palsy patients). Radiographic measures: pre- and postop Kyphosis, Cobb angle, pelvic obliquity, fixation points, levels fused, coronal decompensation. Clinical/Surgical measures: estimated blood loss, time to extubation, complications, length of ICU stay, total hospital stay, rate of transfusions, surgical time. A retrospective chart and XR review of 29 RS and 80 CP patients undergoing PSF from 2005-2022 were analyzed. Patient demographics, perioperative parameters, and X-ray measurements were collected at pre, post, and FU. Furthermore, a sub-analysis was performed comparing the nonambulatory patients. Wilcoxon rank sums test and Chi-square tests were utilized. No significant differences seen in Preop kyphosis (p=0.20) pelvic obliquity (p=0.09), fixation points (p=0.42), levels fused (p=0.79), time to extubation (p=0.53), complication rates (p=0.66), length of ICU (p=0.07) or hospital stay (p=0.71). EBL was significantly higher in CP patients (p=0.01) as was duration of anesthesia (p=0.04), and transfusion volume (p=0.01). However, surgical time (p=0.07) was similar. Preop Cobb was significantly higher for CP patients (p=0.02) as was Postop Cobb (p=0.008). Postop kyphosis (p=0.18) and pelvic obliquity (p=0.09) were similar. Significant differences were found between both Preop (p=0.02) and Postop (p=0.03) coronal decompensation. Sub-analysis of nonambulatory Rett and CP patients showed no significant difference in outcomes. RS patients are comparable to CP patients in terms of surgical and perioperative outcomes. Although CP patients had significantly more EBL, intra-op transfusions, and longer anesthesia