Muscogliati Rodrigo, Masarwa Rawan, Najjar Elie, Daher Mohammad, Meshneb Mostafa, Goswami Ankur, Hassan Ahmed A, Quraishi Nasir A, Patel Mohammed S
Hull York Medical School, University of Hull, Hull, GBR.
Centre for Spinal Studies and Surgery, Queens Medical Centre, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, GBR.
Cureus. 2025 Jul 17;17(7):e88148. doi: 10.7759/cureus.88148. eCollection 2025 Jul.
Pelvic fixation is commonly used in neuromuscular scoliosis patients with pelvic obliquity (PO) >15°, yet its benefit over shorter constructs remains unclear. This systematic review analyzed five studies comprising 230 patients (120 with pelvic fixation (WPF), 110 without pelvic fixation (WoPF)) to assess radiological, functional, and surgical outcomes. Radiographic correction was similar between groups: Cobb angle improved from 62.8° to 32.4° in WPF vs. 76.7° to 29.4° in WoPF (p = 0.54), and PO correction did not differ significantly (final PO 8.6° vs. 11.5°, p = 0.5). Functional outcomes were heterogeneous; only one study reported a statistically significant benefit in the WPF group (Short-Form Health Survey-36 improvement, p = 0.007), while others using Gross Motor Function Classification System (GMFCS), Caregiver Priorities and Child Health Index of Life With Disabilities, or Bridwell's scores found no advantage. GMFCS data were reported in just 19% of patients, limiting subgroup analysis. Estimated blood loss was substantially higher in WPF (2,851 mL vs. 1,383 mL), though not statistically significant (p = 0.17), with comparable complication rates. Given the heterogeneity in outcome measures, surgical technique, and patient function, routine pelvic fixation cannot be universally recommended. However, it may benefit select subgroups, such as non-ambulatory patients with severe PO or poor trunk control, warranting individualized surgical planning.
骨盆固定常用于骨盆倾斜度（PO）>15°的神经肌肉型脊柱侧凸患者，但其相较于较短固定结构的优势尚不清楚。本系统评价分析了五项研究，共纳入230例患者（120例采用骨盆固定（WPF），110例未采用骨盆固定（WoPF）），以评估影像学、功能和手术结局。两组间的影像学矫正相似：WPF组的Cobb角从62.8°改善至32.4°，而WoPF组从76.7°改善至29.4°（p = 0.54），且PO矫正差异无统计学意义（最终PO为8.6°对11.5°，p = 0.5）。功能结局存在异质性；只有一项研究报告WPF组有统计学意义的益处（简明健康调查-36改善，p = 0.007），而其他使用粗大运动功能分类系统（GMFCS）、照顾者优先事项和残疾儿童健康生活指数或Bridwell评分的研究未发现优势。仅19%的患者报告了GMFCS数据，限制了亚组分析。WPF组的估计失血量显著更高（2851 mL对1383 mL），尽管无统计学意义（p = 0.17），并发症发生率相当。鉴于结局测量、手术技术和患者功能的异质性，不能普遍推荐常规骨盆固定。然而，它可能对某些亚组有益，如非行走型且PO严重或躯干控制差的患者，需要个体化的手术规划。
