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Clinical Effectiveness of S2-Alar Iliac Screws in Spinopelvic Fixation in Pediatric Neuromuscular Scoliosis: Systematic Literature Review
| Content Provider | SAGE Publishing |
|---|---|
| Author | Ravindra, Vijay M. Mazur, Marcus D. Brockmeyer, Douglas L. Kraus, Kristin L. Ropper, Alexander E. Hanson, Darrell S. Dahl, Benny T. |
| Copyright Year | 2020 |
| Abstract | 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. |
| Related Links | https://journals.sagepub.com/doi/pdf/10.1177/2192568219899658?download=true |
| Starting Page | 1066 |
| Ending Page | 1074 |
| Page Count | 9 |
| ISSN | 21925682 |
| Issue Number | 8 |
| Volume Number | 10 |
| Journal | Global Spine Journal (GSJ) |
| e-ISSN | 21925690 |
| DOI | 10.1177/2192568219899658 |
| Language | English |
| Publisher | Sage Publications CA |
| Publisher Date | 2020-01-07 |
| Publisher Place | Los Angeles |
| Access Restriction | Open |
| Rights Holder | © The Author(s) 2020 |
| Subject Keyword | scoliosis pediatric correction S2-alar iliac screws neuromuscular pelvic fixation Cobb angle complications pelvic obliquity spinopelvic |
| Content Type | Text |
| Resource Type | Article |
| Subject | Orthopedics and Sports Medicine Neurology (clinical) Surgery |
