Mortality and Causes of Death in Children With Cerebral Palsy With Scoliosis Treated With and Without Surgery
Matti Ahonen, Ilkka Helenius, Mika Gissler, Ira Jeglinsky-Kankainen
Abstract
<h3>Objectives:</h3> To compare mortality and causes of death in scoliotic children with Cerebral palsy (CP) with and without scoliosis surgery. <h3>Methods</h3> National population-based registries were searched for children with CP and scoliosis with and without surgery for scoliosis and were analyzed for comorbidities, mortality, and causes of death. <h3>Results:</h3> Two hundred and thirty-six had not been operated and 238 had been operated for scoliosis during the median follow-up of 17.8 (IQR 11.7-25.7) and 23.0 (IQR 18.4-28.2) years, respectively. Both groups had similar comorbidities. During the follow-up mortality was higher in the non-surgically treated group than in the surgically treated group (n=38/236, 16% and 8.7 per 1000 follow-up years vs. n=29/238, 12% and 5.3 per 1000 follow-up years, p=0.047). In patients with non-surgical treatment cause of death was respiratory in 76.3% (29/38) and 37.9% (11/29) in patients with surgical treatment of scoliosis (6.6 and 2.0 per 1000 follow-up years, p=0.002). Neurological causes of death were more common in surgically treated patients than in non-surgically treated patients, 44.8% (13/29) and 15.8% (6/38), respectively (3.0 and 1.1 per 1000 follow-up years, p=0.009). <h3>Discussion:</h3> Surgical treatment of scoliosis associates to reduced mortality due to respiratory causes in children with cerebral palsy and scoliosis. <h3>Classification of Evidence:</h3> This study provides Class IV evidence of the effects of spinal fusion on mortality of children with severe scoliosis due to CP.