Background: Surgical intervention for scoliosis in the cerebral palsy (CP) population is associated with high rates of postoperative complications. Research regarding whether complications after spinal fusion for CP scoliosis patients affect long-term health-related quality of life (HRQOL) remains limited. The goal of this study was to determine if CP scoliosis patients with major postoperative complications have worse HRQOL 2 years after surgery.

Methods: A retrospective analysis of a prospectively collected, multicenter registry was performed for all patients with nonambulatory CP treated with spinal fusion from 2008 to 2019 with at least 2 years of follow-up. HRQOL was measured through the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) questionnaire. Complications included anything life-threatening, extended hospitalization, spinal cord/nerve injury, or reoperation. Complications were also classified as "existing" or "resolved" based on the 2-year postoperative visit. Patients with existing or unresolved complications at the 2-year postoperative visit were excluded.

Results: There were 298 CP patients operated on during the study period (51% male, mean age: 14.3±3 y). Within this cohort, 208 patients (70.0%) were identified as GMFCS V. 76 patients (26%) experienced a postoperative complication. Seventy-one patients (93%) had a complication that resolved by 2 years postoperatively. Five patients (7%) had complications that did not resolve and required ongoing treatment. The most common complication was infection (13%). There was no difference in CPCHILD total, as well as domain HRQOL scores at 2 years postoperatively between patients without complications and patients with resolved complications (P>0.05). Similarly, there was no difference in mean improvements in CPCHILD total and domain scores at 2 years postoperatively between the no complication and resolved complication cohorts (P>0.05).

Conclusions: Patients with CP scoliosis who experience postoperative complications that resolved by 2 years postoperatively have no significant difference in HRQOL in comparison to those without postoperative complications as measured through the CPCHILD questionnaire. Patients and surgeons can be reassured that despite a high complication rate in CP scoliosis surgery, the initial expectations of improved HRQOL are not diminished as long as the complication is appropriately identified and managed. Methods: Level III.