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. 2022 Jul;10(4):951-964.
doi: 10.1007/s43390-022-00477-w. Epub 2022 Feb 10.

Does the presence of programmable implanted devices in patients with early onset scoliosis alter typical operative and postoperative practices? A survey of spine surgeons

Ryan McMahon  1 , Sara J Morgan  2   3 , Jaysson T Brooks  4 , Patrick Cahill  5 , Ryan Fitzgerald  6 , Ying Li  7 ; Pediatric Spine Study Group; Walter H Truong  8   9   10
Collaborators, Affiliations

Does the presence of programmable implanted devices in patients with early onset scoliosis alter typical operative and postoperative practices? A survey of spine surgeons

Ryan McMahon et al. Spine Deform. 2022 Jul.

Abstract

Purpose: Operative and postoperative management of early onset scoliosis (EOS) patients with programmable implanted devices has not been well characterized in the literature. The aim of this study was to describe current practices for pediatric spine surgeons who operate on patients with these devices.

Methods: An electronic survey was distributed to 167 pediatric spine surgeons between January and March of 2021. The survey queried participants on operative and postoperative management of patients with the following implanted devices: vagal nerve stimulators, ventriculoperitoneal shunts, intrathecal baclofen pumps, pacemakers, and cochlear implants. Descriptive statistics were used to assess survey data.

Results: Fifty-three respondents (31.7% response rate) with a mean 16.5 (SD 12.0) years in practice completed the survey. Depending on the type of device present, surgeons report changing their operative plan anywhere from 28.6 to 60.1% of the time when inserting magnetically controlled growing rods. Most respondents reported performing transcranial motor evoked potentials (80.0-98.0%) and monopolar cautery (70.0-92.9%) across implanted devices. Only 10% (n = 5) of surgeons reported complications related to operative and/or postoperative management of these patients. No complications were related to cautery, neuromonitoring, or surgical placement of MCGRs.

Conclusions: This study demonstrates variation in operative and postoperative management of these patients with various programmable implanted devices. Much of this inconsistency in practice is likely due to decades old case reports, constantly changing device manufacturer recommendations, and/or published simulation studies. Reported heterogeneity in management across surgeons necessitates development of published guidelines regarding proper operative and postoperative management of patients with EOS and implanted devices.

Keywords: Early onset scoliosis; Implanted devices; Spine; Surgery.

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References

    1. Yellin JL, Wiggins CR, Franco AJ et al (2016) Safe transcranial electric stimulation motor evoked potential monitoring during posterior spinal fusion in two patients with cochlear implants. J Clin Monit Comput 30:503–506. https://doi.org/10.1007/s10877-015-9730-7 - DOI - PubMed
    1. Jameson LC (2012) Transcranial motor evoked potentials. Monitoring the nervous system for anesthesiologists and other health care professionals. Springer, Berlin, pp 27–45 - DOI
    1. Bales JG, Colon J, Ramadhyani U et al (2007) Electrocautery-induced asystole in a scoliosis patient with a pacemaker. J Pediatr Orthop B 16:19–22. https://doi.org/10.1097/01.bpb.0000236222.68583.4e - DOI - PubMed
    1. Studer D, Stieger C, Reichlin CJ et al (2019) Spinal surgery with electrically evoked potential monitoring and monopolar electrocautery. Otol Neurotol 40:e7–e13. https://doi.org/10.1097/MAO.0000000000002062 - DOI - PubMed
    1. Lai LP, Egnor MR, Carrion WV et al (2014) Ventricular peritoneal shunt malfunction after operative correction of scoliosis: report of three cases. Spine J 14:e5–e8. https://doi.org/10.1016/j.spinee.2014.08.448 - DOI - PubMed

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