TY - JOUR
T1 - Does the presence of programmable implanted devices in patients with early onset scoliosis alter typical operative and postoperative practices? A survey of spine surgeons
AU - Pediatric Spine Study Group
AU - McMahon, Ryan
AU - Morgan, Sara J.
AU - Brooks, Jaysson T.
AU - Cahill, Patrick
AU - Fitzgerald, Ryan
AU - Li, Ying
AU - Abdullah, Abdullah Saad Abdulfattah
AU - Ahn, Edward
AU - Akbarnia, Behrooz
AU - Akoto, Harry
AU - Albanese, Stephen
AU - Anari, Jason
AU - Anderson, John
AU - Anderson, Richard
AU - Andras, Lindsay
AU - Bauer, Jennifer
AU - Bellaire, Laura
AU - Betz, Randy
AU - Birch, Craig
AU - Blakemore, Laurel
AU - Boachie-Adjei, Oheneba
AU - Bonfield, Chris
AU - Bouton, Daniel
AU - Brassard, Felix
AU - Brockmeyer, Douglas
AU - Brooks, Jaysson
AU - Bumpass, David
AU - Cahill, Pat
AU - Chemaly, Olivier
AU - Cheung, Jason
AU - Cheung, Kenneth
AU - Cho, Robert
AU - Christman, Tyler
AU - Beauchamp, Eduardo Colom
AU - Couture, Daniel
AU - Crawford, Haemish
AU - Crawford, Alvin
AU - Dahl, Benny
AU - Demirkiran, Gokhan
AU - Devito, Dennis
AU - Diab, Mohammad
AU - Sebaie, Hazem El
AU - El-Hawary, Ron
AU - Emans, John
AU - Erickson, Mark
AU - Fabregas, Jorge
AU - Farley, Frances
AU - Farrington, David
AU - Gomez, Jaime
AU - Schulz, Jacob
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Scoliosis Research Society.
PY - 2022/7
Y1 - 2022/7
N2 - Purpose: Operative and postoperative management of early onset scoliosis (EOS) patients with programmable implanted devices has not been well characterized in the literature. The aim of this study was to describe current practices for pediatric spine surgeons who operate on patients with these devices. Methods: An electronic survey was distributed to 167 pediatric spine surgeons between January and March of 2021. The survey queried participants on operative and postoperative management of patients with the following implanted devices: vagal nerve stimulators, ventriculoperitoneal shunts, intrathecal baclofen pumps, pacemakers, and cochlear implants. Descriptive statistics were used to assess survey data. Results: Fifty-three respondents (31.7% response rate) with a mean 16.5 (SD 12.0) years in practice completed the survey. Depending on the type of device present, surgeons report changing their operative plan anywhere from 28.6 to 60.1% of the time when inserting magnetically controlled growing rods. Most respondents reported performing transcranial motor evoked potentials (80.0–98.0%) and monopolar cautery (70.0–92.9%) across implanted devices. Only 10% (n = 5) of surgeons reported complications related to operative and/or postoperative management of these patients. No complications were related to cautery, neuromonitoring, or surgical placement of MCGRs. Conclusions: This study demonstrates variation in operative and postoperative management of these patients with various programmable implanted devices. Much of this inconsistency in practice is likely due to decades old case reports, constantly changing device manufacturer recommendations, and/or published simulation studies. Reported heterogeneity in management across surgeons necessitates development of published guidelines regarding proper operative and postoperative management of patients with EOS and implanted devices.
AB - Purpose: Operative and postoperative management of early onset scoliosis (EOS) patients with programmable implanted devices has not been well characterized in the literature. The aim of this study was to describe current practices for pediatric spine surgeons who operate on patients with these devices. Methods: An electronic survey was distributed to 167 pediatric spine surgeons between January and March of 2021. The survey queried participants on operative and postoperative management of patients with the following implanted devices: vagal nerve stimulators, ventriculoperitoneal shunts, intrathecal baclofen pumps, pacemakers, and cochlear implants. Descriptive statistics were used to assess survey data. Results: Fifty-three respondents (31.7% response rate) with a mean 16.5 (SD 12.0) years in practice completed the survey. Depending on the type of device present, surgeons report changing their operative plan anywhere from 28.6 to 60.1% of the time when inserting magnetically controlled growing rods. Most respondents reported performing transcranial motor evoked potentials (80.0–98.0%) and monopolar cautery (70.0–92.9%) across implanted devices. Only 10% (n = 5) of surgeons reported complications related to operative and/or postoperative management of these patients. No complications were related to cautery, neuromonitoring, or surgical placement of MCGRs. Conclusions: This study demonstrates variation in operative and postoperative management of these patients with various programmable implanted devices. Much of this inconsistency in practice is likely due to decades old case reports, constantly changing device manufacturer recommendations, and/or published simulation studies. Reported heterogeneity in management across surgeons necessitates development of published guidelines regarding proper operative and postoperative management of patients with EOS and implanted devices.
KW - Early onset scoliosis
KW - Implanted devices
KW - Spine
KW - Surgery
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U2 - 10.1007/s43390-022-00477-w
DO - 10.1007/s43390-022-00477-w
M3 - Article
C2 - 35143030
AN - SCOPUS:85131902385
SN - 2212-134X
VL - 10
SP - 951
EP - 964
JO - Spine deformity
JF - Spine deformity
IS - 4
ER -