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. 2015 Apr 23:10:14.
doi: 10.1186/s13013-015-0035-x. eCollection 2015.

Complications associated with surgical repair of syndromic scoliosis

Benjamin J Levy  1 , Jacob F Schulz  1 , Eric D Fornari  1 , Adam L Wollowick  2
Affiliations

Complications associated with surgical repair of syndromic scoliosis

Benjamin J Levy et al. Scoliosis. .

Abstract

Background: There are a number of syndromes that have historically been associated with scoliosis e.g.: Marfan, Down, and Neurofibromatosis. These syndromes have been grouped together as one etiology of scoliosis, known as syndromic scoliosis. While multiple studies indicate that these patients are at high risk for perioperative complications, there is a paucity of literature regarding the collective complication rates and surgical needs of this population.

Methods: PubMed and Embase databases were searched for literature encompassing the surgical complications associated with the surgical management of patients undergoing correction of scoliosis in the syndromic scoliosis population. Following exclusion criteria, 24 articles were analyzed for data regarding these complications.

Results: The collective complication rates and findings of these articles were categorized based on specific syndrome. The rates and types of complications for each syndrome and the special needs of patients with each syndrome are discussed. Several complication trends of note were observed, including but not limited to the universally nearly high rate of wound infections (>5% in each group), high rate of pulmonary complications in patients with Rett syndrome (29.2%), high rate (>10%) of dural tears in Marfan and Ehlers-Danlos syndrome patients, high rate (>20%) of implant failure in Down and Prader-Willi syndrome patients, and high rate (>25%) of pseudarthrosis in Down and Ehlers-Danlos patients.

Conclusions: Though these syndromes have been classically grouped together under the umbrella term "syndromic," there may be specific needs for patients with each of these ailments. Given the high rate of complications, further research is necessary to understand the unique needs for each of these patient groups in the preoperative, intraoperative, and postoperative settings.

Keywords: Complications; Down; Marfan; Nuerofibromatosis; Rett; Scoliosis; Surgical; Syndromic.

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Figures

Figure 1
Figure 1
Pre-operative radiograph of 15 year-old male with Marfan syndrome.
Figure 2
Figure 2
Pre-operative radiograph of 15 year-old male with Marfan syndrome.
Figure 3
Figure 3
Pre-operative MRI of a representative patient with Marfan syndrome.
Figure 4
Figure 4
Post-operative radiograph of the same 15 year-old male.
Figure 5
Figure 5
Post-operative radiograph of the same 15 year-old male.
Figure 6
Figure 6
Preoperative radiograph of 12 year-old female with Down syndrome.
Figure 7
Figure 7
Preoperative radiograph of 12 year-old female with Down syndrome.
Figure 8
Figure 8
Post-operative image of the same patient at our institution.
Figure 9
Figure 9
Post-operative image of the same patient at our institution.
Figure 10
Figure 10
Preoperative radiograph of 12 year-old female with NF.
Figure 11
Figure 11
Preoperative radiograph of 12 year-old female with NF.
Figure 12
Figure 12
Post-operative image of the same patient.
Figure 13
Figure 13
Post-operative image of the same patient.
Figure 14
Figure 14
Preoperative radiograph of a 14 year old with Prader-Willi syndrome.
Figure 15
Figure 15
Preoperative radiograph of a 14 year old with Prader-Willi syndrome.
Figure 16
Figure 16
Post-operative image of the same patient.
Figure 17
Figure 17
Post-operative image of the same patient.
See this image and copyright information in PMC

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