Background and Goal of Study: The purpose of this retrospective audit is to identify factors related with postoperative complications in children undergoing neuromuscular scoliosis surgery. 
Materials and Methods: Data from 24 neuromuscular scoliosis patients operated between September 2013- September 2016 were retrieved retrospectively. SPSS 21 program, Fisher's exacts and Mann Whitney tests were used for statistics.
Results and Discussion: Data was available for 24 children, 14 females-10 males, 9-16 years old, 18-72 kg (mean 39). Scoliosis was result of Cerebral Palsy in 10 cases (41.6%), Spinal muscular atrophy II in 3 (12.5%), Duchenne in 2 (8.3%) and of Arthrogryposis, Prader Willi, Centronuclar Myopathy, Ehlers Dahnlos, Neurofibromatosis, Dravet, Friedreich´s ataxia, Congenital leykodystrophy PMD, Congenital muscular dystrophy, in 1 child each (4.1%). Growth rod was inserted in 11 cases  (45.8%) or 13-14 vertebrae levels were fused in 13 cases (54,2%).
TIVA was used in all cases, as well as low ketamine infusion, tranexamic acid, cell saver and a transfusion trigger of Hb 8g/dl.
At least 1 postoperative complication were recorded in 11 cases (45.8%): pulmonary oedema (1 case), pneumothorax (1), pulmonary embolism (1), respiratory failure -reintubation (1), unplanned need for non-invasive mechanical ventilation (2), bradycardia and hypotension (1), elevated liver enzymes (1), wound infection (3), wound rapture (1), meralgia paresthetica requiring medication (1), blood loss requiring transfusion >2 PRBC (5). Prolonged hospital stay (12,74 days mean) was also considered.
Complications were recorded in: 57% of the female and 50% of the male, 46% of the growth rod cases and 63% of the vertebrae fusion cases, 50% of those with pre-existing respiratory and 52% of those with cardiac conditions, 71% of cases with walking disability, 80% of epileptic children and 80% of the transfused>2 PRBC. Complicated versus non-complicated cases had: mean age 12.8 vs 13.7 years, BMI 17.9 vs 18.2, Cobb angle 96.30 vs 93.10, FVC 59.5 vs 63.8, FEV/FVC 103.8 vs 104.8, preoperative Hb:12.7 vs 11.7mg/dl, duration of surgery 5.8 vs 5.2h, hospital stay 12.8 vs 12.6 days, ICU stay 3 vs 2.2 days. Statistic significance (p< 0.05) was reached for the walking disability factor and the prolonged ICU stay. 
Conclusion(s): Walking disability may increase complications after neuromuscular scoliosis surgery. Complications may prolong ICU stay.

Postoperative complications after spinal surgery in children with neuromuscular scoliosis