Ambulatory Neuromuscular Scoliosis Patients have Superior Perioperative Results than Non-Ambulatory Neuromuscular Scoliosis Patients and Can Approach Adolescent Idiopathic Scoliosis Outcomes After Posterior Spinal Fusion.

STUDY DESIGN Retrospective cohort study. OBJECTIVE This study aims to identify differences in perioperative outcomes between ambulatory patients with Neuromuscular Scoliosis (ANMS) and Adolescent Idiopathic Scoliosis (AIS) following spinal fusion. SUMMARY OF BACKGROUND DATA NMS patients have severe curves with more comorbidities and procedural complexity. These patients require extensive fusion levels, increased blood loss, and suffer increased periop complications. However, NMS patients have a variable severity spectrum, including ambulation status. METHODS Chart and radiographic review of NMS and AIS patients undergoing PSF from 2005-2018. NNMS included NMS patients who were completely dependent (GMFCS IV-V). ANMS consisted of community ambulators without significant reliance on wheeled assistive devices (GMFCS I-III). Sub-analysis matched by age, gender, levels fused and preoperative Cobb angle was conducted as well. Wilcoxon Rank-Sum, Kruskal-Wallis, Chi-Square and Fisher's Exact tests were performed. RESULTS There were 120 patients in the NNMS group, 54 in ANMS and 158 in the AIS group. EBL was significantly lower for ANMS and AIS patients (p   0.05) to AIS. CONCLUSIONS Our data shows radiographic outcomes, infections, revisions, and overall complications for ANMS were similar to the AIS population. This suggests that NMS patients who ambulate primarily without assistance can expect surgical outcomes comparable to AIS patients with further room for improvement in length of ICU and hospital stay.Level of Evidence: 4.