BMI change following spinal fusion for neuromuscular scoliosis surgery
Study design Retrospective descriptive, multi-center study. Objectives We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery. Summary of background data Cachexia and low body mass index is common among children with cerebral palsy (CP). Many in...
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| Veröffentlicht in: | Spine deformity 2020-10, Vol.8 (5), p.1081-1087 |
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| creator | Baldwin, Keith D. Cahill, Patrick J. Sponseller, Paul D. Abel, Mark F. Spiegel, David A. Flynn, John M. Pahys, Josh M. |
| description | Study design
Retrospective descriptive, multi-center study.
Objectives
We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery.
Summary of background data
Cachexia and low body mass index is common among children with cerebral palsy (CP). Many interventions are undertaken to assist the child in nourishment and to obtain a more normal body mass. Additionally, scoliosis is common among children with CP. In our practice we have noted weight gain post operatively in severely underweight children after spinal fusion.
Methods
We underwent a retrospective review of a CP cohort from a multicenter prospective registry. Percentiles on the CP specific growth chart for which each child belonged were plotted based on the patients’ age, weight, gender, GMFCS level, and tube feeding status. We then assessed percentile change in patients between pre-op visit, 1 year, 2 years and for those with available data, 5 years follow up visits. Patients with under two years of follow up, patients with GMFCS III and below, and patients without weight data were excluded.
Results
We identified a total of 211 potentially eligible patients from a multicenter prospective registry. 109 had complete 2 years data to analyze and 37 patients had full 5 years data to analyze. We found that patients under the 50th percentile pre-operatively increased their percentile on the CP growth chart for weight 12.1 percentiles (95% CI 6.7, 17.5
p
value |
| doi_str_mv | 10.1007/s43390-020-00109-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2401808629</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2401808629</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-d5e7d9567c0f1acbfc9de1fba62fa4b7b951f1fa134f497f9b5a456aa34084613</originalsourceid><addsrcrecordid>eNp9kMtKAzEUhoMottS-gAuZpZvR3OaSpRarQsWNgruQySR1SjqpOQ3Stzd1apceOBdO_vMTPoQuCb4hGFe3wBkTOMc0JSZY5OQEjSklNCesqE-PM_8YoSnACqeoa07q4hyNGGWCpzJG8_uX50x_qn5pMuud899dv8xg0_XKZTZC5_u0D1lvYvDrCDo6FTLQ3nUeOsgghqUJuwt0ZpUDMz30CXqfP7zNnvLF6-Pz7G6Ra8arbd4WpmpFUVYaW6J0Y7VoDbGNKqlVvKkaURBLrErftlxUVjSF4kWpFOO45iVhE3Q9-G6C_4oGtnLdgTbOqd74CJJyTGpcl1QkKR2kOniAYKzchG6twk4SLPcI5YBQJoTyF6Hc-18d_GOzNu3x5A9YErBBAOkpQQty5WNIsOA_2x-tFXyn</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2401808629</pqid></control><display><type>article</type><title>BMI change following spinal fusion for neuromuscular scoliosis surgery</title><source>SpringerNature Journals</source><creator>Baldwin, Keith D. ; Cahill, Patrick J. ; Sponseller, Paul D. ; Abel, Mark F. ; Spiegel, David A. ; Flynn, John M. ; Pahys, Josh M.</creator><creatorcontrib>Baldwin, Keith D. ; Cahill, Patrick J. ; Sponseller, Paul D. ; Abel, Mark F. ; Spiegel, David A. ; Flynn, John M. ; Pahys, Josh M. ; Harms Study Group Investigators ; Harms Study Group Investigators</creatorcontrib><description>Study design
Retrospective descriptive, multi-center study.
Objectives
We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery.
Summary of background data
Cachexia and low body mass index is common among children with cerebral palsy (CP). Many interventions are undertaken to assist the child in nourishment and to obtain a more normal body mass. Additionally, scoliosis is common among children with CP. In our practice we have noted weight gain post operatively in severely underweight children after spinal fusion.
Methods
We underwent a retrospective review of a CP cohort from a multicenter prospective registry. Percentiles on the CP specific growth chart for which each child belonged were plotted based on the patients’ age, weight, gender, GMFCS level, and tube feeding status. We then assessed percentile change in patients between pre-op visit, 1 year, 2 years and for those with available data, 5 years follow up visits. Patients with under two years of follow up, patients with GMFCS III and below, and patients without weight data were excluded.
Results
We identified a total of 211 potentially eligible patients from a multicenter prospective registry. 109 had complete 2 years data to analyze and 37 patients had full 5 years data to analyze. We found that patients under the 50th percentile pre-operatively increased their percentile on the CP growth chart for weight 12.1 percentiles (95% CI 6.7, 17.5
p
value < 0.001) whereas patients that began at the 50th percentile or above on average lost 2.2 percentiles (95% CI −6.8, 2.3) though the change was not statistically significant (
p
value 0.330). These changes appeared stable at 5 years. Although regression analysis showed that Cobb correction and pelvic obliquity correction, and hyperlordosis were not independent predictors of the change, we noted that patients with residual curves after surgery of 40° or more experienced 13.3 percentile less weight gain than those with better corrections.
Conclusions
Patients with CP are at risk for cachexia, malnutrition, reflux and other GI disorders. Data presented here suggests that corrective spinal surgery may improve weight percentile in patients who start out at 50th percentile and lower. Patients with 40° or greater of residual scoliosis may benefit less from spinal fusion than those with a better correction.
Level of evidence
II; Prognostic retrospective cohort study.</description><identifier>ISSN: 2212-134X</identifier><identifier>EISSN: 2212-1358</identifier><identifier>DOI: 10.1007/s43390-020-00109-1</identifier><identifier>PMID: 32394323</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Case Series ; Medicine ; Medicine & Public Health ; Orthopedics</subject><ispartof>Spine deformity, 2020-10, Vol.8 (5), p.1081-1087</ispartof><rights>Scoliosis Research Society 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-d5e7d9567c0f1acbfc9de1fba62fa4b7b951f1fa134f497f9b5a456aa34084613</citedby><cites>FETCH-LOGICAL-c347t-d5e7d9567c0f1acbfc9de1fba62fa4b7b951f1fa134f497f9b5a456aa34084613</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s43390-020-00109-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s43390-020-00109-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32394323$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baldwin, Keith D.</creatorcontrib><creatorcontrib>Cahill, Patrick J.</creatorcontrib><creatorcontrib>Sponseller, Paul D.</creatorcontrib><creatorcontrib>Abel, Mark F.</creatorcontrib><creatorcontrib>Spiegel, David A.</creatorcontrib><creatorcontrib>Flynn, John M.</creatorcontrib><creatorcontrib>Pahys, Josh M.</creatorcontrib><creatorcontrib>Harms Study Group Investigators</creatorcontrib><creatorcontrib>Harms Study Group Investigators</creatorcontrib><title>BMI change following spinal fusion for neuromuscular scoliosis surgery</title><title>Spine deformity</title><addtitle>Spine Deform</addtitle><addtitle>Spine Deform</addtitle><description>Study design
Retrospective descriptive, multi-center study.
Objectives
We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery.
Summary of background data
Cachexia and low body mass index is common among children with cerebral palsy (CP). Many interventions are undertaken to assist the child in nourishment and to obtain a more normal body mass. Additionally, scoliosis is common among children with CP. In our practice we have noted weight gain post operatively in severely underweight children after spinal fusion.
Methods
We underwent a retrospective review of a CP cohort from a multicenter prospective registry. Percentiles on the CP specific growth chart for which each child belonged were plotted based on the patients’ age, weight, gender, GMFCS level, and tube feeding status. We then assessed percentile change in patients between pre-op visit, 1 year, 2 years and for those with available data, 5 years follow up visits. Patients with under two years of follow up, patients with GMFCS III and below, and patients without weight data were excluded.
Results
We identified a total of 211 potentially eligible patients from a multicenter prospective registry. 109 had complete 2 years data to analyze and 37 patients had full 5 years data to analyze. We found that patients under the 50th percentile pre-operatively increased their percentile on the CP growth chart for weight 12.1 percentiles (95% CI 6.7, 17.5
p
value < 0.001) whereas patients that began at the 50th percentile or above on average lost 2.2 percentiles (95% CI −6.8, 2.3) though the change was not statistically significant (
p
value 0.330). These changes appeared stable at 5 years. Although regression analysis showed that Cobb correction and pelvic obliquity correction, and hyperlordosis were not independent predictors of the change, we noted that patients with residual curves after surgery of 40° or more experienced 13.3 percentile less weight gain than those with better corrections.
Conclusions
Patients with CP are at risk for cachexia, malnutrition, reflux and other GI disorders. Data presented here suggests that corrective spinal surgery may improve weight percentile in patients who start out at 50th percentile and lower. Patients with 40° or greater of residual scoliosis may benefit less from spinal fusion than those with a better correction.
Level of evidence
II; Prognostic retrospective cohort study.</description><subject>Case Series</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><issn>2212-134X</issn><issn>2212-1358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKAzEUhoMottS-gAuZpZvR3OaSpRarQsWNgruQySR1SjqpOQ3Stzd1apceOBdO_vMTPoQuCb4hGFe3wBkTOMc0JSZY5OQEjSklNCesqE-PM_8YoSnACqeoa07q4hyNGGWCpzJG8_uX50x_qn5pMuud899dv8xg0_XKZTZC5_u0D1lvYvDrCDo6FTLQ3nUeOsgghqUJuwt0ZpUDMz30CXqfP7zNnvLF6-Pz7G6Ra8arbd4WpmpFUVYaW6J0Y7VoDbGNKqlVvKkaURBLrErftlxUVjSF4kWpFOO45iVhE3Q9-G6C_4oGtnLdgTbOqd74CJJyTGpcl1QkKR2kOniAYKzchG6twk4SLPcI5YBQJoTyF6Hc-18d_GOzNu3x5A9YErBBAOkpQQty5WNIsOA_2x-tFXyn</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Baldwin, Keith D.</creator><creator>Cahill, Patrick J.</creator><creator>Sponseller, Paul D.</creator><creator>Abel, Mark F.</creator><creator>Spiegel, David A.</creator><creator>Flynn, John M.</creator><creator>Pahys, Josh M.</creator><general>Springer International Publishing</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20201001</creationdate><title>BMI change following spinal fusion for neuromuscular scoliosis surgery</title><author>Baldwin, Keith D. ; Cahill, Patrick J. ; Sponseller, Paul D. ; Abel, Mark F. ; Spiegel, David A. ; Flynn, John M. ; Pahys, Josh M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-d5e7d9567c0f1acbfc9de1fba62fa4b7b951f1fa134f497f9b5a456aa34084613</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Case Series</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baldwin, Keith D.</creatorcontrib><creatorcontrib>Cahill, Patrick J.</creatorcontrib><creatorcontrib>Sponseller, Paul D.</creatorcontrib><creatorcontrib>Abel, Mark F.</creatorcontrib><creatorcontrib>Spiegel, David A.</creatorcontrib><creatorcontrib>Flynn, John M.</creatorcontrib><creatorcontrib>Pahys, Josh M.</creatorcontrib><creatorcontrib>Harms Study Group Investigators</creatorcontrib><creatorcontrib>Harms Study Group Investigators</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Spine deformity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baldwin, Keith D.</au><au>Cahill, Patrick J.</au><au>Sponseller, Paul D.</au><au>Abel, Mark F.</au><au>Spiegel, David A.</au><au>Flynn, John M.</au><au>Pahys, Josh M.</au><aucorp>Harms Study Group Investigators</aucorp><aucorp>Harms Study Group Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>BMI change following spinal fusion for neuromuscular scoliosis surgery</atitle><jtitle>Spine deformity</jtitle><stitle>Spine Deform</stitle><addtitle>Spine Deform</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>8</volume><issue>5</issue><spage>1081</spage><epage>1087</epage><pages>1081-1087</pages><issn>2212-134X</issn><eissn>2212-1358</eissn><abstract>Study design
Retrospective descriptive, multi-center study.
Objectives
We hypothesize that a post-operative weight gain will result in patients who are underweight prior to surgery.
Summary of background data
Cachexia and low body mass index is common among children with cerebral palsy (CP). Many interventions are undertaken to assist the child in nourishment and to obtain a more normal body mass. Additionally, scoliosis is common among children with CP. In our practice we have noted weight gain post operatively in severely underweight children after spinal fusion.
Methods
We underwent a retrospective review of a CP cohort from a multicenter prospective registry. Percentiles on the CP specific growth chart for which each child belonged were plotted based on the patients’ age, weight, gender, GMFCS level, and tube feeding status. We then assessed percentile change in patients between pre-op visit, 1 year, 2 years and for those with available data, 5 years follow up visits. Patients with under two years of follow up, patients with GMFCS III and below, and patients without weight data were excluded.
Results
We identified a total of 211 potentially eligible patients from a multicenter prospective registry. 109 had complete 2 years data to analyze and 37 patients had full 5 years data to analyze. We found that patients under the 50th percentile pre-operatively increased their percentile on the CP growth chart for weight 12.1 percentiles (95% CI 6.7, 17.5
p
value < 0.001) whereas patients that began at the 50th percentile or above on average lost 2.2 percentiles (95% CI −6.8, 2.3) though the change was not statistically significant (
p
value 0.330). These changes appeared stable at 5 years. Although regression analysis showed that Cobb correction and pelvic obliquity correction, and hyperlordosis were not independent predictors of the change, we noted that patients with residual curves after surgery of 40° or more experienced 13.3 percentile less weight gain than those with better corrections.
Conclusions
Patients with CP are at risk for cachexia, malnutrition, reflux and other GI disorders. Data presented here suggests that corrective spinal surgery may improve weight percentile in patients who start out at 50th percentile and lower. Patients with 40° or greater of residual scoliosis may benefit less from spinal fusion than those with a better correction.
Level of evidence
II; Prognostic retrospective cohort study.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32394323</pmid><doi>10.1007/s43390-020-00109-1</doi><tpages>7</tpages></addata></record> |
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| source | SpringerNature Journals |
| subjects | Case Series Medicine Medicine & Public Health Orthopedics |
| title | BMI change following spinal fusion for neuromuscular scoliosis surgery |
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