Early Post-Op Complications Identified in Rett Syndrome

Respiratory, gastrointestinal post-op complications common after spinal fusion for scoliosis

FRIDAY, Dec. 2 (HealthDay News) -- A high rate of early postoperative medical complications is seen among patients with Rett syndrome (RS) undergoing spinal fusion, according to a study published online Nov. 19 in Spine.

Peter G. Gabos, M.D., from the Alfred I. duPont Hospital for Children in Wilmington, Del., and colleagues examined postoperative complications in 16 female patients with RS. Participants underwent posterior spinal fusion and unit rod instrumentation for progressive scoliosis between 1995 and 2003, and were followed-up for a minimum of two years. The control group comprised 32 patients with spastic quadriplegia, matched for age, level of neurologic impairment, and medical complexity, who underwent the same procedure during the same time period.

The investigators identified 28 major and 37 minor complications, indicating a high rate of early medical complications in RS patients. Every patient had at least one minor gastrointestinal and/or respiratory complication, and only one patient did not have a major medical complication. Major respiratory and gastrointestinal complications accounted for 61 and 21 percent, respectively, of all major complications, and were seen in 10 and 6 patients, respectively. Disseminated intravascular coagulopathy, subacute bacterial endocarditis, sacral decubiti requiring surgical debridement, and extensive bilateral heterotopic ossification of hips were also major complications. No cases of instrumentation failure, pseudarthrosis, deep infection, or rod revision requirement were seen. Similar postoperative complication scores were observed among patients with spastic quadriplegic pattern cerebral palsy.

"Spinal fusion for scoliosis in RS can give a satisfactory technical result, but a high rate of early postoperative medical problems should be anticipated," the authors write.

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