Spinal fusion wound complication risk factors for children — 5 findings

Spine

A study published in Spine examines wound complication rate and risk factors for adolescent patients undergoing spinal arthrodesis.

The study included data from the National Surgical Quality Improvement Program from 50 pediatric centers. There were 1,915 cases where children underwent thoracic or lumbar spinal fusion and 67 patients had wound complications — 3.5 percent.

 

Here are five things to know about the study:

 

1. There were risk factors identified for wound complications; among those patients:

 

•    4.35 percent had congenital diagnoses
•    4.67 percent had neuromuscular diagnoses
•    2.7 percent had idiopathic diagnoses
•    1.61 percent had infantile diagnoses.

 

2. Patients who underwent fusions extending to the pelvis or osteotomy were at higher risk for wound complication. Nearly 10 percent had procedures extending to the pelvis and almost 5 percent had an osteotomy.

 

3. When patients reported longer hospital stays, their risk for wound complications increased. The patients who had longer operative times and higher body mass index were also at higher risk.

 

4. Comorbidities were reported as a predictor of wound complications. Patients with cardiac, gastrointestinal, neurological or pulmonary comorbidities were more likely to have a wound infection.

 

5. A multivariate analysis showed increased wound complication risk among patients who had these independent factors:

 

•    BMI more than 30
•    Cardiac risk factors
•    Fusions extending to the pelvis

 

"These data should be useful for patients' counseling and for preoperative risk stratification," concluded the study authors. "Interventions for minimizing wound complication risk may be most applicable to the high-risk group identified here."

 

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