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Correlation of a preoperative grading scale with progressive spinal deformity following surgery for intramedullary spinal cord tumors in children
Journal of Neurosurgery: Pediatrics, 10/06/08

McGirt MJ et al. - In a study to assess the use of a preoperative grading scale that correlates with postoperative development of progressive spinal deformity requiring subsequent fusion, it seems that use of this grading scheme in a series of resected pediatric intramedullary spinal cord tumors (IMSCTs) has demonstrated its correlation with the incidence of postoperative progressive spinal deformity requiring fusion. Use of a standardized grading scheme will assist in surgical decision making and postoperative evaluation

Methods

Data obtained in 164 pts who underwent resection of an IMSCT at a single institution were retrospectively collected and analyzed to determine the development of progressive spinal deformity requiring fusion
A grading scale (range I–V) was created based on presence or absence of 4 preoperative variables: preoperative scoliosis, involvement of the thorocolumbar junction, age <13 yrs, and number of surgeries for an IMSCT
The grading scale was then retrospectively applied to this series of 164 children to assess the correlation of variables with subsequent spinal deformity

Results

9 pts presented with Grade I status, 41 pts with Grade II, 58 pts with Grade III, 44 pts with Grade IV, and 12 pts with Grade V
44 pts developed progressive spinal deformity requiring fusion at a mean follow-up of 5 yrs after surgery
A higher preoperative grade was associated with an increasing need for subsequent fusion for progressive spinal deformity: Grade I [0%], Grade II [5%], Grade III [26%], Grade IV [40%], and Grade V status [75%]

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