Review of spinal surgeries in Crumlin finds no metalwork issues

The review comes amid a number of other reviews being carried out into spinal surgery done in CHI at Temple Street following serious safety concerns there. Picture: Conor Ó Mearáin / Collins Photo Agency

A review by CHI at Crumlin of spinal surgery for children with spina bifida has not identified any metalwork failures or need for removal of metalwork, the published review shows.

The review of care for 11 children found “wound infection was the only significant complication”. The team found no deaths were recorded during the review period.

This review, published on Thursday morning, comes amid a number of other reviews being carried out into spinal surgery done in CHI at Temple Street following serious safety concerns there.

Last week, a review of the Temple Street unit found high levels of postoperative complications and infection, including two serious incidents and the death of one patient. One consultant has been referred to the Medical Council and the care of children on waiting lists is being transferred to Crumlin.

Both hospitals are part of the Children’s Health Ireland (CHI) hospital group in Dublin.

CHI undertook the review of the procedures in Crumlin as part of its internal quality assurance processes. 

The key findings of the Crumlin review were:

• Six of the 11 patients (55%) developed a post-operative infection with five of the 11 (45%) needing to return to theatre for wound management.
• None of the patients had metalwork failure following their procedure in this time period or needed replacement of metalwork during the review period.

However, the team also identified “one patient with CNS spinal fluid leak”, one patient had “metalwork fragments removed from previous surgery”, one child had “nutritional deficit” and one suffered with “psychological distress”.

In a statement, the hospital said: “It should be noted that given the low number of patients in this review, any comparison to other papers in the literature and CHI at Temple Street clinical review data should be interpreted with caution, as the spectrum of surgeries are not necessarily similar.” 

A hospital spokeswoman said members of the CHI executive have already seen and assessed the Crumlin findings. She said they “are assured by the results” from this review.

“In addition, and important to note, no clinical concerns about spinal surgery outcomes have been raised by the multi-professional teams in CHI at Crumlin to date,” she said.

In the published review, it says 11 children met the criteria for inclusion. Their care was reviewed using a template also applied by the Boston Children’s Hospital during their separate review of care at the Temple St site.

Among this group eight had spinal fusions, one had a growth rod inserted and two underwent rod lengthening. “Within this cohort, six had post-operative infections and all of these had infectious diseases involvement,” the review states.

“There were no mechanical failures resulting in removal of metalwork post-surgery performed within the review time frame. There were no deaths recorded by one year post-op.” 

However, the review does state one child who had had MAGEC rods inserted in 2017 had these removed during the review time. This was “due to disconnection and migration into pelvis”, the report states.

The clinical outcomes review of CHI at Crumlin was commissioned by the Chief Medical Officer of CHI and co-ordinated by the Research Nurse in Orthopaedics CHI at Crumlin overseen by the Head of the Orthopaedic Department CHI at Crumlin.

The review was reviewed and approved by the Clinical Director of CHI at Crumlin. The review can be read on the CHI website.