Iliac Screw Fixation in Neuromuscular Scoliosis

Abstract

The use of screw fixation in the ilium as a means of spinopelvic anchorage is safe and effective in the treatment of neuromuscular scoliosis. The use of 2 screws in each iliac wing provides more stable fixation with fewer implant-related complications than using a single screw.

Pelvic fixation for neuromuscular scoliosis deformity correction

“…Complications directly involving iliac screws are mainly rod disengagement from the lateral connector and radiolucencies around the screws [67,71]. Interestingly, the addition of a second iliac screw on each side was associated with significantly fewer implant-related complications in a comparative retrospective review.…”

“…Pelvic obliquity correction associated with such techniques range from 59 to 83.3 % with no pseudarthrosis reported [32,67,68,71,72]. Complications directly involving iliac screws are mainly rod disengagement from the lateral connector and radiolucencies around the screws [67,71].…”

“…Interestingly, the addition of a second iliac screw on each side was associated with significantly fewer implant-related complications in a comparative retrospective review. This additional pair of screws is inserted with an entry point 2 cm further superiorly to the first ones and is attached to the rod with a lateral connector as well [71]. The use of iliac screws combined with sacral screws as a low profile alternative to iliosacral screws in neuromuscular patients with body weight less than 35 kg has been recently reported in a prospective study [73].…”

“…Most authors report this technique for the treatment of neuromuscular scoliosis in pediatric patients without additional sacral fixation. Proximal spinal anchorage is done with sublaminar wires [67,71] or with pedicle screws from the L5 level [32,33,72].…”

Resultado a largo plazo de las fusiones largas espinopelvicas en escoliosis: importancia de la edad, la capacidad de marcha y el tipo de fijación ilíaca

“…7 Currently, the most widespread and most widely used technique for spinopelvic fusion is the bilateral iliac screw, and numerous biomechanical and clinical studies demonstrate the superiority of this distal anchorage system when compared to previous techniques, especially the Galveston system. [8][9][10][11][12] Iliac screws are easier to place, but lysis 13,14 and implant failures in the spinopelvic connection 15,16 are not uncommon. Classically, the literature presents a high percentage of non-fusion following long spinopelvic fusions 17 and these percentages have not been significantly reduced by the use of iliac screws, so that nowadays it continues to be a surgical technique that involves a high number of reinterventions, both in primary and revision fusions.…”