Spine deformity · 2026
The influence of intrathecal baclofen pumps on outcomes following spinal fusion in non-ambulatory patients with cerebral palsy.
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Larson Lexi M, Miller Daniel J, Torres-Gonzalez Luis, Guillaume Tenner J, Truong Walter H, Perra Joseph H, Krach Linda E, Williams Maykala J, Morgan Sara J
Аннотация
PURPOSE: Children with non-ambulatory cerebral palsy (CP) often have neuromuscular scoliosis (NMS) that requires surgical correction. Many of these children also have co-existing spasticity treated with an intrathecal baclofen pump (ITBP). Theoretically, ITBPs can complicate spine surgery due to the proximity of the pump and catheter to the surgical area, but the evidence on effects of ITBP on spinal deformity surgery outcomes is varied. The aim of this study was to compare surgical outcomes and incidence of complications between children with and without ITBPs.
METHODS: This retrospective study included children with CP from a single center who underwent spinal fusion between 2001 and 2021. Complications and outcomes were abstracted from the medical record and compared between those with and without ITBP using Fisher's exact tests or Mann-Whitney U tests.
RESULTS: A total of 334 patients were eligible (ITBP: n = 163; no ITBP: n = 171). In general, children with ITBP were not more likely to experience complications compared to those without (p = 0.19). However, those with ITBP had greater odds of surgical site infection (OR 3.11, p = 0.03), longer surgery duration (p < 0.001), and higher percentage of blood loss (p = 0.01). ITBP-related complications occurred in 11% of children with ITBP.
CONCLUSIONS: The presence of ITBP did not increase the general risk of complications for children with ITBP. However, children with ITBP experienced more surgical site infections, longer surgery durations, and a higher percentage of blood loss. Results will improve counseling between surgeons, children, and caregivers regarding the risk of spinal fusion surgery when ITBPs are present.
METHODS: This retrospective study included children with CP from a single center who underwent spinal fusion between 2001 and 2021. Complications and outcomes were abstracted from the medical record and compared between those with and without ITBP using Fisher's exact tests or Mann-Whitney U tests.
RESULTS: A total of 334 patients were eligible (ITBP: n = 163; no ITBP: n = 171). In general, children with ITBP were not more likely to experience complications compared to those without (p = 0.19). However, those with ITBP had greater odds of surgical site infection (OR 3.11, p = 0.03), longer surgery duration (p < 0.001), and higher percentage of blood loss (p = 0.01). ITBP-related complications occurred in 11% of children with ITBP.
CONCLUSIONS: The presence of ITBP did not increase the general risk of complications for children with ITBP. However, children with ITBP experienced more surgical site infections, longer surgery durations, and a higher percentage of blood loss. Results will improve counseling between surgeons, children, and caregivers regarding the risk of spinal fusion surgery when ITBPs are present.