Evaluation of pelvic fixation in neuromuscular scoliosis: a retrospective study in 55 patients

Abstract

The literature has described different indications for pelvic fixation in neuromuscular scoliosis. We retrospectively evaluated changes in pelvic obliquity for a minimum of two years among three groups: group I (initial pelvic obliquity >15°; with pelvic fixation), group II (initial pelvic obliquity >15°; without pelvic fixation), and group III (initial pelvic obliquity <15°; without pelvic fixation). We used iliac screws for pelvic fixation in group I. There was significant postoperative improvement (p<0.0001) in Cobb's angle and pelvic obliquity. There was no significant loss of correction in Cobb's angle, thoracic kyphosis, and lumbar lordosis among all three groups; however, group II showed significant correction loss in pelvic obliquity compared to groups I and III at final follow-up (p<0.0001). Our results indicate that patients who have pelvic obliquity >15°require pelvic fixation to maintain the correction and balance over time while obliquity <15°does not require pelvic fixation.

Early limited instrumentation of scoliosis in Duchenne muscular dystrophy: is a single-rod construct sufficient?

“…The resulting 10 absence of movement at the lumbo-pelvic junction, may adversely affect seating and 11 pressure distribution, while retention of mobility at the lumbosacral junction has 12 advantages in transferring and performing weight shifts while sitting [22,23]. Pelvic 13 obliquity greater than 15° was demonstrated by Modi et al as requiring pelvic fixation 14 [24]. No patient in this series progressed to greater than 15° obliquity thus obviating 15 this additional measure.…”

Effects of Surgical Correction of Neuromuscular Scoliosis on Gastric Myoelectrical Activity, Emptying, and Upper Gastrointestinal Symptoms

“…Operative techniques including instrumentations with pedicle screws, hooks and iliac screws, and spinal osteotomies have been described elsewhere (10)(11)(12). In addition to this, 10 (63%) patients in the spastic group and 8 (53%) patients in the flaccid group underwent anterior release (resection of intervertebral discs and anterior ligaments) and fusion of the spine.…”

Perioperative complications associated with spine surgery in patients with established spinal cord injury

“…In the presence of neuromuscular curves resulting in significant coronal plane deformity, it is well accepted to extend the fusion past the lumbosacral junction [48][49][50][51][52]. There are no data to guide decision making for fusion levels in patients with sagittal plane deformities and chronic SCI.…”