A new pelvic rod system for the surgical correction and fixation of pelvic obliquity in pediatric neuromuscular scoliosis

Abstract

PURPOSE: To describe surgical outcomes using the new device in pediatric neuromuscular scoliosis. METHODS: All patients with neuromuscular disorders requiring surgery with pelvic fixation for the correction of scoliosis in the period 2002-2009 were operated by the new pelvic rod fixation device. Coronal and sagittal alignment before and after surgery until the latest follow-up were evaluated by standard X-rays. Intraoperative and postoperative complications were recorded. RESULTS: All 18 study patients (mean age at surgery 15 years, range 10-27) achieved solid fusion at a mean follow-up of 41 months. The coronal Cobb angle improved from 82° ± 31° (range 36-168) to 33° ± 25° at the last follow-up (range 9-95 months) (P < 0.0001). Pelvic obliquity improved from 19° ± 6° (range 10-30) to 5° ± 5° (range 0-14) (P < 0.0001). Early complications included pneumonia, urinary tract infection, disseminated intravascular coagulation (DIC), and hypovolemic shock. Three patients required debriding and received prolonged antimicrobial therapy for deep wound infection (none required implant removal). At the latest follow-up, no patient complained of lumbar pain or worsening of ambulatory status or level of activity. CONCLUSION: Surgery employing the new pelvic rod fixation device allowed solid fusion and fixation with significant correction of multiplanar deformity, but the complication rate was high.