Three different techniques for pelvic fixation in the management of neuromuscular scoliosis in nonambulatory spastic cerebral palsy: A comparative study of Galveston Rod, iliac screw, and sacroiliac screw.

IF 1.1 4区 医学 Q3 ORTHOPEDICS Acta orthopaedica et traumatologica turcica Pub Date : 2022-11-01 DOI:10.5152/j.aott.2022.22080
Armağan Can Ulusaloğlu, Ali Asma, J Richard Bowen, Suken A Shah
{"title":"Three different techniques for pelvic fixation in the management of neuromuscular scoliosis in nonambulatory spastic cerebral palsy: A comparative study of Galveston Rod, iliac screw, and sacroiliac screw.","authors":"Armağan Can Ulusaloğlu,&nbsp;Ali Asma,&nbsp;J Richard Bowen,&nbsp;Suken A Shah","doi":"10.5152/j.aott.2022.22080","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical and radiographic results of three different pelvic fixation techniques, i.e., Galveston Rod, Iliac Screw, and Sacroiliac Screw, in managing neuromuscular scoliosis in nonambulatory children with spastic cerebral palsy (CP).</p><p><strong>Methods: </strong>This retrospective study included nonambulatory children aged < 18 years with neuromuscular scoliosis secondary to CP, undergoing a spinal fusion and pelvic fixation by either Galveston rod, iliac screw, or sacroiliac screw techniques. The primary outcome variable was to determine the stability of the major curve angle and pelvic obliquity over timeline intervals for each pelvic fixation tech nique. The two radiographic parameters were measured at five timeline intervals and were compared to define stability among the groups.</p><p><strong>Results: </strong>One hundred and one patients (54 females [53%]) with spastic nonambulatory CP met the inclusion criteria; the mean age at sur gery was 13.5±3.1 years. Mean follow-up intervals were first-year (12.9±1.5) and second-year (25.8±2.5). Forty-one patients had minimum five-year (81.5±23 months) postoperative follow-up. Groups were based on pelvic fixation techniques: 25 patients with the Galveston rod, 24 with the iliac screw, and 52 with the sacroiliac screw. Of the 41 patients with a minimum five-year follow-up, 10 had the Galveston rod, 11 had an iliac screw, and 20 had sacroiliac screw fixation. Gross Motor Function Classification System level, medical comorbidities, intra thecal baclofen pump, and vitamin D level were compared with each pelvic fixation technique (P > .05). Major curve angle parameters were measured at the five timelines as 70.5°±21.1°, 15.7°±13°, 15.7°±12°, 17.5°±12.7°, and 15.1°±9.6°, and pelvic obliquity as 14.8°±10.4°, 4.9°±4.2°, 5.7°±4.6°, 5°±4.4°, and 7.2°±4.4°, respectively. After the surgery, corrected major curve angle and pelvic obliquity showed no sta tistically significant difference between pelvic fixation techniques (P > .05) and remained stable over timeline intervals (P > .05). Fifteen patients had complications requiring additional surgery. The iliac screw group (nine patients) had the highest rate of complications.</p><p><strong>Conclusion: </strong>All three pelvic fixation techniques can provide equivalent correction for major curve angle and pelvic obliquity in managing neuromuscular scoliosis in nonambulatory CP children. Pelvic obliquity after surgery may remain stable regardless of pelvic fixation type. A higher rate of postoperative complication can be encountered with the iliac screw.</p><p><strong>Level of evidence: </strong>Level III, Retrospective Study.</p>","PeriodicalId":7097,"journal":{"name":"Acta orthopaedica et traumatologica turcica","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/40/aott-56-6-372.PMC9885728.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta orthopaedica et traumatologica turcica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5152/j.aott.2022.22080","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: This study aimed to compare the clinical and radiographic results of three different pelvic fixation techniques, i.e., Galveston Rod, Iliac Screw, and Sacroiliac Screw, in managing neuromuscular scoliosis in nonambulatory children with spastic cerebral palsy (CP).

Methods: This retrospective study included nonambulatory children aged < 18 years with neuromuscular scoliosis secondary to CP, undergoing a spinal fusion and pelvic fixation by either Galveston rod, iliac screw, or sacroiliac screw techniques. The primary outcome variable was to determine the stability of the major curve angle and pelvic obliquity over timeline intervals for each pelvic fixation tech nique. The two radiographic parameters were measured at five timeline intervals and were compared to define stability among the groups.

Results: One hundred and one patients (54 females [53%]) with spastic nonambulatory CP met the inclusion criteria; the mean age at sur gery was 13.5±3.1 years. Mean follow-up intervals were first-year (12.9±1.5) and second-year (25.8±2.5). Forty-one patients had minimum five-year (81.5±23 months) postoperative follow-up. Groups were based on pelvic fixation techniques: 25 patients with the Galveston rod, 24 with the iliac screw, and 52 with the sacroiliac screw. Of the 41 patients with a minimum five-year follow-up, 10 had the Galveston rod, 11 had an iliac screw, and 20 had sacroiliac screw fixation. Gross Motor Function Classification System level, medical comorbidities, intra thecal baclofen pump, and vitamin D level were compared with each pelvic fixation technique (P > .05). Major curve angle parameters were measured at the five timelines as 70.5°±21.1°, 15.7°±13°, 15.7°±12°, 17.5°±12.7°, and 15.1°±9.6°, and pelvic obliquity as 14.8°±10.4°, 4.9°±4.2°, 5.7°±4.6°, 5°±4.4°, and 7.2°±4.4°, respectively. After the surgery, corrected major curve angle and pelvic obliquity showed no sta tistically significant difference between pelvic fixation techniques (P > .05) and remained stable over timeline intervals (P > .05). Fifteen patients had complications requiring additional surgery. The iliac screw group (nine patients) had the highest rate of complications.

Conclusion: All three pelvic fixation techniques can provide equivalent correction for major curve angle and pelvic obliquity in managing neuromuscular scoliosis in nonambulatory CP children. Pelvic obliquity after surgery may remain stable regardless of pelvic fixation type. A higher rate of postoperative complication can be encountered with the iliac screw.

Level of evidence: Level III, Retrospective Study.

Abstract Image

Abstract Image

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
三种不同的骨盆固定技术治疗非活动痉挛性脑瘫患者的神经肌肉性脊柱侧凸:加尔维斯顿棒、髂螺钉和骶髂螺钉的比较研究。
目的:本研究旨在比较Galveston棒、髂螺钉和骶髂螺钉三种不同骨盆固定技术治疗痉挛性脑瘫(CP)患儿神经肌肉性脊柱侧凸的临床和影像学结果。方法:本回顾性研究纳入年龄< 18岁的继发性CP神经肌肉性脊柱侧凸的非卧床儿童,采用Galveston棒、髂螺钉或骶髂螺钉技术进行脊柱融合和骨盆固定。主要结局变量是确定每种骨盆固定技术在时间间隔内的主曲线角度和骨盆倾斜度的稳定性。在五个时间间隔测量两个放射参数,并比较各组之间的稳定性。结果:101例(女性54例[53%])痉挛性非动态CP符合纳入标准;平均手术年龄13.5±3.1岁。平均随访时间为第一年(12.9±1.5)和第二年(25.8±2.5)。41例患者术后至少随访5年(81.5±23个月)。根据骨盆固定技术分组:25例Galveston棒,24例髂螺钉,52例骶髂螺钉。在41例至少随访5年的患者中,10例采用Galveston棒,11例采用髂螺钉,20例采用骶髂螺钉固定。比较两种骨盆固定技术大运动功能分类系统水平、医疗合并症、鞘内巴氯芬泵、维生素D水平(P > 0.05)。测量5个时间线的主要曲线角度参数分别为70.5°±21.1°、15.7°±13°、15.7°±12°、17.5°±12.7°和15.1°±9.6°,骨盆倾角分别为14.8°±10.4°、4.9°±4.2°、5.7°±4.6°、5°±4.4°和7.2°±4.4°。手术后,矫正后的大弯角和骨盆倾角在不同骨盆固定技术间无统计学差异(P > 0.05),且在时间间隔内保持稳定(P > 0.05)。15名患者出现并发症,需要进行额外手术。髂螺钉组(9例)并发症发生率最高。结论:三种骨盆固定技术在治疗非活动CP患儿的神经肌肉性脊柱侧凸时均能提供相同的主弯角和骨盆斜度矫正。无论骨盆固定类型如何,手术后骨盆斜度都可以保持稳定。髂螺钉的术后并发症发生率较高。证据等级:III级,回顾性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
2.00
自引率
0.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Acta Orthopaedica et Traumatologica Turcica (AOTT) is an international, scientific, open access periodical published in accordance with independent, unbiased, and double-blinded peer-review principles. The journal is the official publication of the Turkish Association of Orthopaedics and Traumatology, and Turkish Society of Orthopaedics and Traumatology. It is published bimonthly in January, March, May, July, September, and November. The publication language of the journal is English. The aim of the journal is to publish original studies of the highest scientific and clinical value in orthopedics, traumatology, and related disciplines. The scope of the journal includes but not limited to diagnostic, treatment, and prevention methods related to orthopedics and traumatology. Acta Orthopaedica et Traumatologica Turcica publishes clinical and basic research articles, case reports, personal clinical and technical notes, systematic reviews and meta-analyses and letters to the Editor. Proceedings of scientific meetings are also considered for publication. The target audience of the journal includes healthcare professionals, physicians, and researchers who are interested or working in orthopedics and traumatology field, and related disciplines.
期刊最新文献
An investigation into the frequency and risk factors of low back pain following surgical treatment of isolated calcaneal fractures Comparison of artificial intelligence algorithm for the diagnosis of hip fracture on plain radiography with decision-making physicians: a validation study Peculiar reaction of oxidized zirconium from a total knee arthroplasty prosthesis: A case report An investigation into the frequency and risk factors of low back pain following surgical treatment of isolated calcaneal fractures Comparison of artificial intelligence algorithm for the diagnosis of hip fracture on plain radiography with decision-making physicians: a validation study
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1