Straighten things out in advance: Palliative care consultation prior to posterior spinal fusion for high-risk neuromuscular scoliosis patients

Introduction: Patients with neuromuscular scoliosis undergo posterior spinal fusion (PSF) surgery with the hopes of preventing respiratory disease, optimizing positioning and functioning, and sometimes to improve pain. While studies show quality of life benefit from PSF for many children with neuromuscular scoliosis, there remains significant post-operative morbidity and even mortality risk. Preliminary studies have attempted to correlate preoperative risk factors with the likelihood of postoperative complications (1). However, the outcomes of PSF in the subset of neuromuscular scoliosis patients who have multifactorial respiratory failure have not been specifically studied …