Abstract summary 

Multi-center, prospective, observational cohort.To compare myelopathic vs. non-myelopathic ambulatory patients in short- and long-term neurologic function, operative treatment, and patient-reported outcomes.Pediatric deformity patients from 16 centers were enrolled with the following inclusion criteria: aged 10-21 years-old, a Cobb angle ≥100° in either the coronal or sagittal plane or any sized deformity with a planned 3-column osteotomy, and community ambulators. Patients were dichotomized into 2 groups: myelopathic (abnormal preoperative neurologic exam with signs/symptoms of myelopathy) and non-myelopathic (no clinical signs/symptoms of myelopathy).Of 311 patients with an average age of 14.7 ± 2.8 years, 29 (9.3%) were myelopathic and 282 (90.7%) were non-myelopathic. There was no difference in age ( = 0.18), gender ( = 0.09), and Risser Stage ( = 0.06), while more patients in the non-myelopathic group had previous surgery (16.1% vs. 3.9%; = 0.03). Mean lower extremity motor score (LEMS) in myelopathic patients increased significantly compared to baseline at every postoperative visit: Baseline: 40.7 ± 9.9; Immediate postop: 46.0 ± 7.1, = 0.02; 1-year: 48.2 ± 3.7, < 0.001; 2-year: 48.2 ± 7.7, < 0.001). The non-myelopathic group had significantly higher LEMS immediately postoperative ( = 0.0007), but by 1-year postoperative, there was no difference in LEMS between groups (non-myelopathic: 49.3 ± 3.6, myelopathic: 48.2 ± 3.7, = 0.10) and was maintained at 2-years postoperative (non-myelopathic: 49.2 ± 3.3, myelopathic: 48.2 ± 5.7, = 0.09). Both groups improved significantly in all SRS domains compared to preoperative, with no difference in scores in the domains for pain ( = 0.12), self-image ( = 0.08), and satisfaction ( = 0.83) at latest follow-up.In severe spinal deformity pediatric patients presenting with preoperative myelopathy undergoing spinal reconstructive surgery, myelopathic patients can expect significant improvement in neurologic function postoperatively. At 1-year and 2-year postoperative, neurologic function was no different between groups. While non-myelopathic patients had significantly higher postoperative outcomes in SRS mental-health, function, and total-score, both groups had significantly improved outcomes in every SRS domain compared to preoperative.

Authors & Co-authors:  Cerpa Meghan M Zuckerman Scott L SL Lenke Lawrence G LG Kelly Michael P MP Yaszay Burt B Newton Peter P Sponseller Paul P Erickson Mark M Garg Sumeet S Pahys Joshua J Samdani Amer A Cahill Patrick P McCarthy Richard R Bumpass David D Sucato Daniel D Boachie-Adjei Oheneba O Shah Suken S Gupta Munish M

Study Outcome 

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