Department of Orthopedic Surgery, Korea University Anam Hospital, 73 Goryeodae-ro Seongbuk-gu, Seoul, 02841, Korea.
Department of Orthopedic Surgery, Spine Center, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, 1342, Dongil-ro, Nowon-gu, Seoul, 01757, Korea.
Sci Rep. 2023 Jun 20;13(1):9993. doi: 10.1038/s41598-023-36981-w.
Pelvic fixation is performed to obtain proper coronal and sagittal alignment when the pelvic obliquity is more than 15º in patients with neuromuscular scoliosis (NMS). Since many NMS patients were wheelchair or bed-ridden status, there has been controversy on the effect of pelvic fixation. Therefore, the purpose of this study is to analyze the effects of pelvic fixation on correction of spinal deformity and quality of life (QoL) in NMS patients. A total of 77 NMS patients who underwent deformity correction were divided into three groups and retrospectively analyzed preoperatively, postoperatively, and at 2-year follow-up: pelvic fixation group (Group A, n = 16), fixed to S1 (Group B, n = 33), and fixed to L5 (Group C, n = 28). The correction rate of scoliosis was 60.0%, 58.0%, and 56.7% in groups A, B, and C, respectively, with no statistical difference (P > 0.05). The correction rate of pelvic obliquity was 61.3%, 42.8%, and 57.5% in respective groups A, B, and C, with no significance (P > 0.05). The correction loss of scoliosis and pelvic obliquity showed no statistical significance between three groups for 2-year follow-up (all Ps > 0.05). There were no significant differences regarding clinical outcomes and postoperative complications among the three groups (all Ps > 0.05). Therefore, pelvic fixation using iliac screws is not substantially influencing radiological and clinical outcomes in the patients with NMS.
骨盆固定术用于矫正神经肌肉性脊柱侧凸（NMS）患者骨盆倾斜超过 15°时的冠状位和矢状位对线。由于许多 NMS 患者处于轮椅或卧床状态，骨盆固定的效果存在争议。因此，本研究旨在分析骨盆固定对 NMS 患者脊柱畸形矫正和生活质量（QoL）的影响。共纳入 77 例接受畸形矫正的 NMS 患者，分为三组，回顾性分析术前、术后和 2 年随访时的情况：骨盆固定组（A 组，n=16），固定至 S1（B 组，n=33）和固定至 L5（C 组，n=28）。A、B 和 C 组的脊柱侧凸矫正率分别为 60.0%、58.0%和 56.7%，差异无统计学意义（P>0.05）。A、B 和 C 组骨盆倾斜矫正率分别为 61.3%、42.8%和 57.5%，差异无统计学意义（P>0.05）。三组患者术后 2 年随访时，脊柱侧凸和骨盆倾斜的矫正丢失无统计学差异（均 P>0.05）。三组患者的临床结果和术后并发症无显著差异（均 P>0.05）。因此，在 NMS 患者中，使用髂骨螺钉进行骨盆固定不会显著影响影像学和临床结果。
