Samdani et al identified risk factors for perioperative complications following spine surgery performed on a patient with cerebral palsy. The authors are from multiple institutions in the United States and Canada.


Patient selection: spine surgery in a patient with cerebral palsy


Outcome: any major complication (divided into pulmonary, gastroinestinal, other medical, neurologic, wound infection, unplanned staged surgery and instrumentation related


Risk factors for major perioperative complications:

(1) staged procedure

(2) greater preoperative kyphosis (affecting T2 to T12)

(3) greater estimated blood loss (EBL)



• The mean EBL for patients with complications was 2,843 mL +/- 1,732 mL. Patients without complications had an EBL ranging from 400 to 2,806 mL. The risk would therefore be an EBL > 2,800 mL.

• Kyphosis in patients with complications ranged from 27 to 69 degrees vs 16 to 63 degrees in patients without complications.


Factors associated with fewer complications:

(1) use of an antifibrinolytic agent


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