CHEN Ting,FAN Qing,SHEN Pin,et al.Evaluation of pelvic fixation in neuromuscular scoliosis.[J].Journal of Clinical Pediatric Surgery,,9():0.
Evaluation of pelvic fixation in neuromuscular scoliosis.
- Keywords:
- Pelvis; Neuromuscular Manipestations; Scoliosis/CN
- Abstract:
- Objectives To evaluate the indications of pelvic fixation in neuromuscular scoliosis patients. Methods We have measured the change in pelvic obliquity over a period of 25 months among three groups; group I with initial pelvic obliquity > 15° and pelvic fixation, group Ⅱwith initial pelvic obliquity > 15° and without pelvic fixation and group III with initial pelvic obliquity < 15° and without pelvic fixation. All patients underwent for correction and fusion for neuromuscular scoliosis using posterior-only pedicle screw instrumentations. We have used iliac screws for pelvic fixation in selected patient group. Results Comparing the Cobb's angle correction among all three groups there is significant correction post operatively and at final follow-up. There is no significant loss of correction among all three groups. However, when pelvic obliquity was compared in all three groups displayed significant correction post operatively,but group II exhibited significant loss of correction at final follow-up when compared with group I and group III. Conclusions Patients who have pelvic obliquity less than 15° do not need pelvic fixation and they can maintain the correction during a long period; while patients who have pelvic obliquity more than 15° require pelvic fixation to maintain the correction and balance over a long time.
References:
1 King AG,Thomas KA.Analysis of the STIF Technique for Spino-Pelvic Fixation: Clinical Results in 19 Patients with Neuromuscular Scoliosis[J].Journal of Pediatric Orthopedics, 2000,20:667-676.
2 Hahn F,Hauser D.Scoliosis correction with pedicle screws in Duchenne muscular dystrophy[J].Eur Spine J,2008,17(2):255-261.
3 Sengupta DK,Mehdian SH.Pelvic or Lumbar Fixation for the Surgical Management of Scoliosis in Duchenne Muscular Dystrophy[J].Spine,2002, 27(18):2072-2079.
4 Allen B,Ferguson R.The Galveston technique of pelvic fixation with Luque rod instrumentation of the spine[J].Spine,1984,9:388-394.
5 Wild A,Haak H.Is Sacral Instrumentation Mandatory to Address Pelvic Obliquity in Neuromuscular Thoracolumbar Scoliosis Due to Myelomeningocele? [J].Spine,2001,26(14):325-329.
6 Whitaker C,Burton DC.Treatment of Selected Neuromuscular Patients With Posterior Instrumentation and Arthrodesis Ending With Lumbar Pedicle Screw Anchorage[J].Spine, 2000,25(18):2312-2318.
7 Peelle MW,Lenke LG.Comparison of Pelvic Fixation Techniques in Neuromuscular Spinal Deformity Correction: Galveston Rod Versus Iliac and Lumbosacral Screws[J].Spine, 2006,31(20):2392-2398.
8 Miladi LT,Ghanem IB.Iliosacral Screw Fixation for Pelvic Obliquity in Neuromuscular Scoliosis: A Long-Term Follow-Up Study[J].Spine,1997,22(15):1722-1729.
9 Brook PD,Kennedy JD.Spinal Fusion in Duchenne's Muscular Dystrophy[J].J P O,1996,16(3):324-331.
Memo
1,上海交通大学医学院附属新华医院儿童骨科(200092);2,韩国首尔高丽大学附属九老医院骨科,E-mail:chentingsun@126.com