Cohen JL, et al. - In this retrospective cohort study 21 children with Rett syndrome (RS) and 124 with cerebral palsy (CP), experts ascertained how respiratory failure rates and span of ICU stay following posterior spinal fusion (PSF) for neuromuscular scoliosis contrasted between children with RS vs CP. A larger proportion of CP vs RS patients was in Gross Motor Function Classification System IV or V. In RS patients, respiratory failure was more prevalent, as was PPV. Shorter median durations of anesthesia and surgery were noted in RS patients. A longer median ICU stay was observed in RS patients. The incidence of pneumonia did not vary among groups. Only RS diagnosis and prolonged PPV were related to longer ICU stay. Thus, irrespective of superior preoperative motor function and shorter anesthesia and surgery durations, patients with RS endured more respiratory failure, prolonged PPV use, and longer ICU stays following PSF compared with children with CP.