Known Adrenal Insufficiency Does Not Increase Early Complication Rates Following Posterior Spinal Fusion in Non-Ambulatory Cerebral Palsy Patients
Presenter Status
Resident/Psychology Intern
Abstract Type
Clinical Research
Primary Mentor or Principal Investigator
Dr. Kenneth Aaron Shaw
Presentation Type
Poster
Start Date
19-5-2026 12:00 PM
End Date
19-5-2026 1:00 PM
Abstract Text
Background: Children with non-ambulatory cerebral palsy (CP) who undergo posterior spinal fusion (PSF) typically experience a relative increase in serum cortisol in response to the physiologic stress of surgery. However, some patients with CP are unable to mount an effective hormonal response due to adrenal insufficiency (AI). Previous studies have shown that unrecognized AI can increase the risk for complications following PSF. However, no study to date has investigated the impact of known AI on outcomes following surgery.
Objectives/Goal: The objective of this study was to examine if non-ambulatory cerebral palsy patients with known AI have any significant increased risk of complications after undergoing PSF.
Methods/Design: Retrospective review of a national database.
The TriNetX database was queried to identify non-ambulatory CP patients undergoing PSF. Two cohorts were generated based on a known diagnosis of AI with a 2:1 propensity-matched control based on demographic characteristics, age at PSF, and mortality. Number of complications, length of encounters, severity of complications, and relative risk and odds ratio of complications were compared at 0-3-month and 3-6-month follow-up. Decreases in complications between these follow-up windows were also compared. Complication severity was evaluated with the modified Clavien-Dindo-Sink classification.
Results: 541 patients were identified (mean 12 years, 55% female). Of these, 101 were identified with known AI (mean 11 years, 62% female). After propensity score matching, a control population of 202 patients, matched for age, gender, and ethnicity, were identified. Between group comparisons found no difference in complication development at 0-3 months (mean diff 0.129; p=0.902) or odds of complication development (OR:1.37, 95% C.I. 0.58-3.67; p=0.52). There was also no difference in mean length of hospital stay (mean diff 3.43, p=0.37) or complication severity (p=0.365). At the 3-6-month range, there was no difference in the number of complications (mean diff –1.85; p=0.349), complication severity (p=0.36), or odds of complication development (OR 1.56, 95% C.I. 0.93-2.6; p=0.11).
Conclusions: CP patients with known AI who undergo PSF do not experience any significant increase in risk of complications, complication severity, or encounter length compared to patients without AI. These results suggest that known AI may not significantly influence short-term risk following PSF.
Known Adrenal Insufficiency Does Not Increase Early Complication Rates Following Posterior Spinal Fusion in Non-Ambulatory Cerebral Palsy Patients
Background: Children with non-ambulatory cerebral palsy (CP) who undergo posterior spinal fusion (PSF) typically experience a relative increase in serum cortisol in response to the physiologic stress of surgery. However, some patients with CP are unable to mount an effective hormonal response due to adrenal insufficiency (AI). Previous studies have shown that unrecognized AI can increase the risk for complications following PSF. However, no study to date has investigated the impact of known AI on outcomes following surgery.
Objectives/Goal: The objective of this study was to examine if non-ambulatory cerebral palsy patients with known AI have any significant increased risk of complications after undergoing PSF.
Methods/Design: Retrospective review of a national database.
The TriNetX database was queried to identify non-ambulatory CP patients undergoing PSF. Two cohorts were generated based on a known diagnosis of AI with a 2:1 propensity-matched control based on demographic characteristics, age at PSF, and mortality. Number of complications, length of encounters, severity of complications, and relative risk and odds ratio of complications were compared at 0-3-month and 3-6-month follow-up. Decreases in complications between these follow-up windows were also compared. Complication severity was evaluated with the modified Clavien-Dindo-Sink classification.
Results: 541 patients were identified (mean 12 years, 55% female). Of these, 101 were identified with known AI (mean 11 years, 62% female). After propensity score matching, a control population of 202 patients, matched for age, gender, and ethnicity, were identified. Between group comparisons found no difference in complication development at 0-3 months (mean diff 0.129; p=0.902) or odds of complication development (OR:1.37, 95% C.I. 0.58-3.67; p=0.52). There was also no difference in mean length of hospital stay (mean diff 3.43, p=0.37) or complication severity (p=0.365). At the 3-6-month range, there was no difference in the number of complications (mean diff –1.85; p=0.349), complication severity (p=0.36), or odds of complication development (OR 1.56, 95% C.I. 0.93-2.6; p=0.11).
Conclusions: CP patients with known AI who undergo PSF do not experience any significant increase in risk of complications, complication severity, or encounter length compared to patients without AI. These results suggest that known AI may not significantly influence short-term risk following PSF.
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Poster Board Number: 24