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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

• 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

• 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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