Klane K. White, MD, MSc Viviana Bompadre, PhD Adam J. Kreutzer

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Presentation transcript:

Does the Presence of a Gastrostomy Tube Improve Surgical Outcomes in Early Onset Scoliosis? Klane K. White, MD, MSc Viviana Bompadre, PhD Adam J. Kreutzer Courtney O’Donnell, MD Gregory J. Redding, MD

Introduction Children with Early Onset Scoliosis (EOS) usually start off in poor states of health Vertical Expandable Prosthetic Titanium Rib (VEPTR) implants are associated with a high rate of complications

Hypothesis Prophylactic gastrostomy tube (G-tube) placement improves the general health of the patient and thus reduces the number of complications after VEPTR placement

Methods Retrospective review of all EOS patients who received a VEPTR implant Demographic information: Age, diagnosis, severity of deformity, height, weight, and BMI Determined the presence and duration of G-tube Tabulated major and minor complications. Evaluated correlation between nutritional status, presence/absence of G-tube and complication rate

Results 75 patients with mean of 5.9 years of follow-up Average age at VEPTR implant 6.6 years (range 1.3-19.3 years) 30 received G-tube, 45 did not.

No Association Having and complication and G-tube presence Chi2 =0.843, p=0.772 Number of complications and G-tube presence T-test p=0.17 BMI change* and development of a complication Spearman r=0.18, p=0.122 Cobb angle change* and development of complication *BMI change and Cobb angle change were calculated using the measurement at time of implant and our most recent measurement for each patient.

Associations Fewer complications with increasing age Pearson Correlation r=-0.234 p=0.0435 Multivariate Logistic Regression Analysis: Larger BMI change (p=0.028) and increased age (p=0.024) correlated with fewer complications

Conclusion We were unable to demonstrate a significant effect of G tube presence on complication presence or rate Patients who received G tubes may have started out more nutritionally depleted The study does suggest improved nutritional health (as shown by improved BMI) and increased age correlate with a reduced complication rate

Skeletal Health and Dysplasia Program Thank You!! Orthopedics & Sports Medicine Skeletal Health and Dysplasia Program http://orthopedics.seattlechildrens.org klane.white@seattlechildrens.org 9