Oh, what a surprise, spinal fusion surgery in children with neuromuscular scoliosis is a bit of a dice roll. In the latest episode of “Let’s Play Surgical Complication Bingo,” researchers took a stroll down memory lane, looking at cases from 2012 to 2020, to see just how often these kids hit the complication jackpot within 30 days post-op. And the magic number is… 11%! That’s right, folks, 709 out of 6677 children decided to go for a two-for-one or better on their surgical outcomes.

Now, let’s talk about the most popular complications. If bleeding/transfusion was a pop star, it would be topping the charts at 80%, with pneumonia and reintubation as its loyal groupies at 24% and 18% respectively. But wait, there’s more! If your surgery is longer than the last movie you regretted watching (≥ 400 min), or if the surgeon decides to go for a high score in levels fused (≥ 13), or throws in some pelvic fixation for good measure, congratulations, you’ve increased your odds of complications!

And because life isn’t fair, some kids come with built-in risk factors like being sicker to start with (ASA ≥ 3), having a tricky airway, being cognitively impaired, having seizures, blood disorders, needing a pre-op meal plan, or just being born with extra challenges. But hey, if you’ve got a tracheostomy, you’re actually in luck for once – it’s like a get-out-of-complication-free card.

Finally, in a shocking twist, more complications mean worse outcomes like longer hospital stays, not going home, bouncing back to the hospital, or meeting the Grim Reaper. Who would’ve thought, right?

So, in conclusion, if you’re planning a spinal fusion for a child with neuromuscular scoliosis, maybe take a moment to consider these fun facts. It’s all about that pre-op planning and risk stratification, because, as we all know, forewarned is forearmed. And this, dear friends, is what we call Level IV evidence – not quite a crystal ball, but it’s something.