Effect of pelvic fixation on ambulation in children with neuromuscular scoliosis

Luke Drake, Hamdi Sukkarieh, Tyler McDonald, Eldrin Bhanat, Elisa Quince, Myles Atkins, Patrick Wright, Jaysson Brooks

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND The effect of posterior spinal fusion (PSF) incorporating the pelvis on an ambulatory patient’s ability to mobilize after the fusion is not well understood. AIM To see whether a posterior spinal fusion with pelvic fixation using iliac or sacral alar iliac screws in ambulatory neuromuscular scoliosis (NMS) patients influences postoperative ambulatory ability. METHODS A retrospective review of all patients with NMS that underwent PSF with fixation incorporating the pelvis between January 1, 2012 and February 29, 2019. A total of 118 patients were eligible, including 11 ambulatory patients. The primary outcome was the maintenance of ambulatory status postoperatively. Secondary outcomes included postoperative curve magnitude, pelvic obliquity, and complications, comprising infections, instrumentation failure, and any unplanned returns to the operative room. RESULTS The ambulatory function was maintained in all 11 ambulatory NMS patients. One patient had an improvement in functional status with equipment-free ambulation postoperatively. An average postoperative follow-up was 19 mo. The overall complication rate was 19.4% (n = 23) with no significant differences between the groups in infection (P = 0.365), hardware failure (P = 0.505), and reoperation rate (P = 1.0). Ambulatory status did not affect complication rate (P = 0.967). CONCLUSION Spinal fusion to the pelvis in ambulatory patients with NMS provides effective deformity correction without the reduction in ambulatory capabilities.

Original languageEnglish (US)
Pages (from-to)753-759
Number of pages7
JournalWorld Journal of Orthopedics
Volume13
Issue number8
DOIs
StatePublished - Aug 18 2022

Keywords

  • Ambulation
  • Neuromuscular scoliosis
  • Pediatrics
  • Pelvic fixation
  • Pelvis
  • Posterior spinal fusion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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