ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
The indication of fusion to the pelvis in neuromuscular scoliosis is based on the underlying disease rather than on pelvic obliquity.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Authors' Reply to: "Comment on 'Does pelvic fixation impact reoperation outcomes for neuromuscular scoliosis surgery? A 10-year matched cohort analysis'".Spine deformity · 2026Article
- Optimal distal fusion level in patients with neuromuscular scoliosis: a meta-analysis of comparative studies with 1685 patients over 15 years.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Optimal distal fusion level in patients with neuromuscular scoliosis: a meta-analysis of comparative studies with 1685 patients over 15 years.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Review
- Scoliosis Surgery in a Patient With Advanced Friedreich's Ataxia-It Is Not Too Late.Annals of clinical and translational neurology · 2026Article
- Four-rod technique for neuromuscular scoliosis and pelvic obliquity correction: technical note and case series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Orthopaedic Management in Duchenne Muscular Dystrophy.Journal of the Pediatric Orthopaedic Society of North America · 2025Review
- Current Concepts in the Orthopaedic Management of Duchenne Muscular Dystrophy.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2024Review
- Utilizing robotic-assisted navigation for pelvic instrumentation in pediatric patients with neuromuscular scoliosis: a technical note and case series.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe decision to instrument to L5 or ilium, in NMS, is usually based on radiologic factors, including pelvic obliquity (PO) > 15°, apex of curvature < L3, and Cobb angle > 60°. Since scoliosis in these patients is caused by a neurologic disease, we based our decision to stop at L5 on the presence of spasticity or flaccidity. PATIENTS &
methodsThe senior author did 109 primary fusions in NMS. Of those with DMD or SMA only 16% were instrumented to the ilium. The main factor for our decision was the correction potential of the truncal shift and PO in the supine traction radiographs and the absence of severe spasticity.
resultsThe 57 patients with DMD/SMA had a mean preoperative curvature of 68°, PO of 17°, and truncal shift of 20°. 74% should have been instrumented to the pelvis, but only 16% were. Those instrumented shorter as the rule, were corrected from 74° to 26° and had a postoperative PO of 8°. There was no significant difference in postoperative correction and PO compared to those instrumented to L5 on standard protocol. Subsequent extension to the pelvis was needed in 1 CP patient. There were no significant changes after 2 years. Of the 20 patients instrumented to the pelvis 11 had cerebral palsy and a preop curvature of 89°, a PO of 21° and a truncal shift of 25°. DISCUSSION: The decision on instrumentation length should take flexibility and disease into consideration. If the trunk is centred over the pelvis, deterioration will not occur in absence of spasticity.
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