Multiaxial high-modularity spinopelvis (HMSP) fixation device in neuromuscular scoliosis: a comparative study
- 404 Downloads
To compare radiological and clinical results in patients operated for neuromuscular scoliosis with pelvic fixation using high-modularity spinopelvic screw (HMSP) designed by authors.
Of 54 patients with neuromuscular scoliosis, group 1 comprised of 27 patients with conventional pelvic fixation; and group 2 comprised of 27 patients using HMSP. Results were evaluated radiologically and functionally. We compared preoperative and postoperative complications, especially the loosening or breakage of spinopelvis fixation device, failure of fixation, and the change of shadow around the spinopelvis fixation device.
There was no difference of correctional power, preoperative average Cobb’s angle of each group was 79.8 and 75 to postoperative 30.2 and 28.3 (P < 0.05). Pelvic obliquity improved from average 18.3°–8.9° in group I and average 24.3°–12.5° in group II (P < 0.05). However, there was no difference between two groups (P > 0.05). Average blood loss was 2,698 ml in group 1 and 2,414.8 ml in group 2 (P > 0.05). Average operative time was 360 min in group 1 and 332 min in group 2 (P = 0.30). There was no difference found between two groups regarding gait and functional evaluation. On the all cases of group 1 and 2, the change of shadow around the spinopelvis fixation device was observed. There was one case of the fracture of spinopelvis fixation device in group I.
There was no difference of Cobb’s angle and correctional power between the groups using HMSP when compared with the group using standard spinopelvis fixation device. Therefore, HMSP can be used more effectively in case of neuromuscular scoliosis.
KeywordsNeuromuscular scoliosis Pelvic obliquity Conventional spinopelvic fixation Multiaxial high-modularity spinopelvic fixation
Conflict of interest
Supplementary material 1 (MPG 3294 kb)
- 6.Bridwell KH, Baldus C, Iffrig TM, Lenke LG, Blanke K (1999) Process measures and patient/parent evaluation of surgical management of spinal deformities in patients with progressive flaccid neuromuscular scoliosis (Duchenne’s muscular dystrophy and spinal muscular atrophy). Spine (Phila Pa 1976) 24:1300–1309CrossRefGoogle Scholar
- 20.McCarthy RE, Bruffett WL, McCullough FL (1999) S rod fixation to the sacrum in patients with neuromuscular spinal deformities. Clin Orthop Relat Res:26–31Google Scholar
- 23.Mullender M, Blom N, De Kleuver M, Fock J, Hitters W, Horemans A, Kalkman C, Pruijs J, Timmer R, Titarsolej P, Van Haasteren N, Jager MV, Van Vught A, Van Royen B (2008) A Dutch guideline for the treatment of scoliosis in neuromuscular disorders. Scoliosis 3:14. doi: 10.1186/1748-7161-3-14 PubMedCentralPubMedCrossRefGoogle Scholar
- 24.Peelle MW, Lenke LG, Bridwell KH, Sides B (2006) Comparison of pelvic fixation techniques in neuromuscular spinal deformity correction: Galveston rod versus iliac and lumbosacral screws. Spine (Phila Pa 1976) 31:2392–2398. doi: 10.1097/01.brs.0000238973.13294.16 (discussion 2399) CrossRefGoogle Scholar
- 30.Winter R (1994) Classification and terminology. In: Lonstein J, Bradford D, Winter R, Ogilvie J (eds) Moe’s textbook of scoliosis and other spinal deformities, 3rd edn. W B Saunders, Philadelphia, pp 39–43Google Scholar