Article

This study aims (1) to evaluate and synthesize the evidence for the
postoperative outcomes after scoliosis surgery for children with cerebral palsy
(CP), and (2) to identify preoperative risk factors for adverse outcomes after
surgery. METHOD: Medline, EMBASE, CINAHL, and PubMed were searched for relevant
literature. Included studies were assessed for risk of bias using the Cochrane
Effective Practice and Organisation of Care tool.
Quality of evidence for overall
function, quality of life (QoL), gross motor function, caregiver outcomes,
deformity correction, and postoperative complications were assessed using GRADE
(Grades of Recommendation, Assessment, Development and Evaluation). RESULTS:
Fifty-one studies met inclusion criteria, including 35 case series designs. Risk
of bias was high across all studies. On average good deformity correction was
achieved, the trend appears positive for caregiver and QoL outcomes, but there
was minimal to no change for gross motor or overall function. Inconsistent
measurement limited synthesis. A mean overall complication rate of 38.1% (95%
confidence interval 27.3-53.3) was found. The quality of evidence was very low
across all functional outcomes. INTERPRETATION:
Limited high-quality evidence
exists for outcomes after scoliosis surgery in children with CP, a procedure
associated with a moderately high complication rate.
The intervention appears
indicated for deformity correction, but currently there is insufficient evidence
to make recommendations for this surgery as a way to also improve functional
outcomes, caregiver outcomes, and quality of life.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS