Pediatric tethered cord release: an epidemiological and postoperative complication analysis.

Autor:	Bhimani AD; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA.; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Selner AN; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Patel JB; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Hobbs JG; Section of Neurosurgery, The University of Chicago, Chicago, IL, USA., Esfahani DR; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Behbahani M; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Zayyad Z; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Nikas D; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA., Mehta AI; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Journal of spine surgery (Hong Kong) [J Spine Surg] 2019 Sep; Vol. 5 (3), pp. 337-350.
DOI:	10.21037/jss.2019.09.02
Abstrakt:	Background: Tethered cord release (TCR) is a common procedure in pediatric neurosurgery. Despite a reputation for being relatively safe, the risk factors for postoperative complications are poorly understood. Methods: In this study, the American College of Surgeons-National Surgical Quality Improvement Program Pediatric Database (ACS-NSQIP-P) was reviewed to identify the demographics, risk factors, and 30-day postoperative complications for tethered cord release using univariate and multivariate analysis. A detailed analysis of reasons for readmission and reoperation was also performed. Results: Three thousand and six hundred eighty-two pediatric patients were studied. Males undergoing TCR were younger (5.6 vs . 6.1 years) and had a higher rate of pre-operative comorbidities but lower 30-day complication rate versus females. Patients who later developed complications were more likely to require a microscope intraoperatively, had longer operative times, and worse preoperative American Society of Anesthesiologists (ASA) class. Conclusions: Despite being a relatively safe procedure, TCR in the pediatric population carries a finite risk of complications. In this large, international database study, males were found to have a greater number of risk factors prior to TCR, while females exhibit a higher risk of developing postoperative complications. This paper provides a large sample size of multi institutional pediatric patients undergoing TCR and may serve as a contemporary "snapshot" for future studies. Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare. (2019 Journal of Spine Surgery. All rights reserved.)
Databáze:	MEDLINE
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