O2096: Utility of Abdominal Radiographs After Posterior Spinal Fusion for Neuromuscular Scoliosis

Background: Postoperative ileus is common in neuromuscular scoliosis (NMS) patients following posterior spinal fusion (PSF), and abdominal radiographs (KUBs) are often ordered. We sought to investigate how often KUBs produced meaningful findings that impacted patient care. This information may help providers balance the downsides of KUBs (radiation and increased cost) against possible benefits. We hypothesize that KUBs ordered following PSF increase cost and radiation to the patient but have minimal impact on management.

Methods: Retrospective review of NMS patients treated with PSF between January 2014 and December 2019 at a tertiary pediatric hospital. Electronic medical records and radiographs were reviewed.

Results: 186 patients met inclusion criteria, with a mean age of 13.7  2.8 years (range: 2-20 years) and mean preoperative curve magnitude of 84.6  24.7 degrees (range: 20-170 degrees). Mean follow up was 43.2  33.1 months (range: 0-181 months). 21.5% (40/186) of NMS patients had a KUB due to abdominal pain and/or distension. 97.5% (39/40) of the KUB imaging performed was consistent with ileus. 1 KUB study demonstrated nonspecific findings prompting a general surgery consult; however, patient management was not altered. All cases of ileus resolved.

Conclusion: In this series, KUBs were performed in 1/5 NMS patients during the postoperative period. Although the sample size of 186 may not capture rare events, this study did not demonstrate any benefit or change of treatment from KUBs. This imaging may increase cost and radiation without benefiting the patient and may therefore not be warranted in most cases.