Of Major Complication Types, Only Deep Infections after Spinal Fusion are Associated with Worse Health-Related Outcomes in Children with Cerebral Palsy.

STUDY DESIGN: Retrospective review. OBJECTIVE: To determine whether 1) major postoperative complications ("complications") are associated with 2-year improvements in Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) scores after scoliosis surgery, and 2) complications and preoperative characteristics predict 2-year improvements in CPCHILD Total score. SUMMARY OF BACKGROUND DATA: Spinal arthrodesis can halt the progression of spinal deformity in patients with cerebral palsy (CP)-related scoliosis. However, these patients are prone to postoperative complications. METHODS: Using a multicenter CP registry, we identified 222 patients aged /=2-year follow-up. We compared CPCHILD score improvement between 71 patients who had >/=1 complication ("complications group") versus 151 who did not ("no-complications group"). Complications were deep infections, thromboembolic events, and cardiopulmonary, gastrointestinal, and neurologic complications. Multiple linear regression was used to identify predictors of 2-year postoperative CPCHILD score improvement. Alpha = 0.05. RESULTS: At 2-year follow-up, the complications group had similar mean improvement in CPCHILD score across all domains compared with the no-complications group (p > .05). When stratifying by complication type, deep infection was associated with less improvement in CPCHILD Comfort and Emotions (p = .02), Quality of Life (p < .01), and Total (p = 0.04) scores. When controlling for Gross Motor Function Classification System subcategory, age, and body mass index, only preoperative CPCHILD Total score and postoperative deep infection (F(4, 176) = 14 (p < 0.0001, R = 0.24) predicted 2-year improvement in CPCHILD Total score. Higher preoperative Total score and postoperative deep infection independently predicted less improvement in Total score. CONCLUSIONS: Postoperative deep infection and higher preoperative CPCHILD Total score independently predicted less improvement in CPCHILD Total score. Other major postoperative complications were not associated with differences in 2-year postoperative improvements in CPCHILD scores across all domains. LEVEL OF EVIDENCE: 3.