Clinical Effectiveness of S2-Alar Iliac Screws in Spinopelvic Fixation in Pediatric Neuromuscular Scoliosis: Systematic Literature Review
| Autor: | Marcus D. Mazur, Vijay M. Ravindra, Kristin L. Kraus, Darrell S. Hanson, Benny Dahl, Douglas L. Brockmeyer, Alexander E. Ropper |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
complications
Clinical effectiveness spinopelvic Scoliosis Cobb angle medicine Pelvic fixation Orthopedics and Sports Medicine Pelvic obliquity Review Articles Orthodontics S2-alar iliac screws scoliosis Neuromuscular scoliosis business.industry medicine.disease pelvic fixation Systematic review pediatric Surgery Neurology (clinical) neuromuscular correction pelvic obliquity business |
| Zdroj: | Global Spine Journal |
| ISSN: | 2192-5690 2192-5682 |
| Popis: | Study Design:Systematic literature review.Objectives:To comprehensively review the S2-alar iliac (S2-AI) screw technique for pelvic fixation in pediatric neuromuscular scoliosis.Methods:Articles identified from the PubMed and EMBASE databases were reviewed for relevance and applicability, and the studies were summarized.Results:Eight articles met the inclusion criteria. A total of 277 pediatric patients underwent spinopelvic fixation using S2-AI fixation for neuromuscular scoliosis; the mean follow-up was 3 years (range = 0.75-6 years). Six articles had level III evidence (5 retrospective cohort studies, 1 observational study), and 2 articles had level IV evidence (case series). Wound complications occurred in 34 (12.2%) patients. Instrumentation complications occurred in 36 patients (13.0%), including lucency around the screw (6.5%), screw fracture (3.6%), disengaging of the set/screw or rod from the tulip head (2.8%), and screw displacement (0.7%). Three patients (1.1%) required reoperation for instrumentation failures. The overall reoperation rate—including 3 hardware replacements and 3 cases of L5-S1 pseudarthrosis—was 2.1%. The mean Cobb angle correction was 51.4°, and the mean pelvic obliquity correction was 14.8°; deformity correction was maintained at 3- and 5-year follow-ups. There were 10 (3.6%) cases of implant prominence/implant-related pain, 1 case of sacroiliac joint pain (resolved with longer screw placement), and no major neurological or vascular complications secondary to S2-AI screw placement.Conclusions:This review suggests that the use of S2-AI screws in pediatric neuromuscular scoliosis is efficacious with a reasonable safety profile and provides a useful technique for pelvic fixation in children with scoliosis. |
| Databáze: | OpenAIRE |
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