Language
English
Publication Date
3-8-2026
Journal
Global Spine Journal
DOI
10.1177/21925682261430676
PMID
41796316
PMCID
PMC12971508
PubMedCentral® Posted Date
3-8-2026
PubMedCentral® Full Text Version
Post-print
Abstract
Study Design
Single-center retrospective review.
Objective
To investigate the association between BMI Z-scores and postoperative complications in pediatric patients with neuromuscular scoliosis undergoing spinal instrumentation.
Methods
Pediatric patients who underwent spinal instrumentation for neuromuscular scoliosis from July 2012 to June 2016 with a minimum 2-year follow-up were included. BMI and BMI Z-scores were calculated, and patients were stratified into CDC-defined BMI-for-age percentiles: underweight (< 5th percentile), normal (5th to < 85th percentile), overweight (85th to < 95th percentile), and obese (≥95th percentile). Logistic regression assessed associations of BMI, BMI Z-score, and BMI groups with postoperative complications.
Results
In total, 147 patients were included. Average follow-up was 3.2 ± 1.4 years. The most common diagnosis was cerebral palsy (39.5%). Complications occurred in 65 (44.2%) patients: 32 (21.8%) had a surgical site infection (SSI), 10 (6.8%) developed pneumonia, and 24 (16.3%) required return to the operating room within 90 days. Higher BMI Z-score was associated with increased odds of deep SSI (OR = 1.50, P = 0.039), 30-day readmission (OR = 1.45, P = 0.045), and reoperation within 90 days (OR = 1.52, P = 0.026), and decreased odds of pneumonia (OR = 0.77, P = 0.041). Similar associations were seen for BMI.
Conclusion
Higher BMI Z-scores were associated with increased odds of deep SSI, readmission within 30 days, and return to the operating room within 90 days. Lower BMI Z-scores were associated with increased risk of developing pneumonia; however, this should be interpreted with caution as these patients had baseline pulmonary comorbidities. BMI Z-scores may be a useful adjunct for preoperative risk stratification in pediatric neuromuscular scoliosis patients undergoing spinal instrumentation.
Level of Evidence
Prognostic Level III.
Keywords
neuromuscular scoliosis, BMI z-score, pediatric spinal instrumentation
Published Open-Access
yes
Recommended Citation
Mihas, Alexander K; Birhiray, Dion; Hung, Chun Wai; et al., "Association Between BMI Z-Score and Postoperative Complications in Pediatric Neuromuscular Scoliosis Surgery" (2026). Faculty, Staff and Students Publications. 7418.
https://digitalcommons.library.tmc.edu/baylor_docs/7418