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Study design <p>Single-arm meta-analysis and systematic review.</p> Objectives <p>To evaluate the safety and efficacy of pelvic fixation in the surgical treatment of neuromuscular scoliosis (NMS).</p> Methods <p>A comprehensive search on PubMed, Embase and the Cochrane Library was performed to identify studies that included NMS treated with surgery. Changes in mean coronal curve angle (Cobb angle), pelvic obliquity (PO), thoracic kyphosis (TK), lumbar lordosis (LL), and other important surgical outcomes were evaluated and analyzed at baseline, postoperatively, and final follow-up. Surgical-related parameters and postoperative major complications were collected.</p> Results <p>A total of 29 studies comprising 1595 NMS patients were included in the meta-analysis. The mean operative time was 311.75&#xa0;min, and the estimated blood loss was 1787.69&#xa0;ml. The results demonstrated a significant reduction in the Cobb angle after surgery with pelvic fixation (mean reduction: 47.57°, 95% CI 43.04–52.10). PO was also significantly corrected (mean reduction: 13.71°, 95% CI 12.26–15.16). In addition, there was an improvement in TK (mean reduction: 7.42°, 95% CI 0.47–14.36) and an increase in LL (mean increase: 4.79°, 95% CI 9.73–0.16). Among the cohort of 1489 patients, 262 patients (17.6%) experienced implant-related complications, while 225 patients (15.1%) developed infections, neurological complications were observed in 7 patients (0.5%), revision surgeries were required for 86 patients (5.8%) and the overall mortality rate reached 0.7% (10 cases in total). These pooled radiographic corrections are clinically relevant to wheelchair sitting balance and overall spino-pelvic alignment in NMS, supporting pre-operative counseling about the functional value of pelvic fixation.</p> Conclusions <p>Pelvic fixation provides effective deformity and pelvic obliquity correction with acceptable complication rates. These pooled data offer benchmark reference values to guide surgical counseling and trial design.</p>

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Safety and efficacy of long spinal fusion to the pelvis for the treatment of neuromuscular scoliosis: single-arm meta-analysis and systematic review

  • 期刊论文

  • 发表日期：

    2025年11月11日

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  • Zhangfu Li,
  • Duan Sun,
  • Bo Han,
  • Honghao Yang,
  • Yangpu Zhang,
  • Lijin Zhou,
  • Yong Hai

摘要

Study design

Single-arm meta-analysis and systematic review.

Objectives

To evaluate the safety and efficacy of pelvic fixation in the surgical treatment of neuromuscular scoliosis (NMS).

Methods

A comprehensive search on PubMed, Embase and the Cochrane Library was performed to identify studies that included NMS treated with surgery. Changes in mean coronal curve angle (Cobb angle), pelvic obliquity (PO), thoracic kyphosis (TK), lumbar lordosis (LL), and other important surgical outcomes were evaluated and analyzed at baseline, postoperatively, and final follow-up. Surgical-related parameters and postoperative major complications were collected.

Results

A total of 29 studies comprising 1595 NMS patients were included in the meta-analysis. The mean operative time was 311.75 min, and the estimated blood loss was 1787.69 ml. The results demonstrated a significant reduction in the Cobb angle after surgery with pelvic fixation (mean reduction: 47.57°, 95% CI 43.04–52.10). PO was also significantly corrected (mean reduction: 13.71°, 95% CI 12.26–15.16). In addition, there was an improvement in TK (mean reduction: 7.42°, 95% CI 0.47–14.36) and an increase in LL (mean increase: 4.79°, 95% CI 9.73–0.16). Among the cohort of 1489 patients, 262 patients (17.6%) experienced implant-related complications, while 225 patients (15.1%) developed infections, neurological complications were observed in 7 patients (0.5%), revision surgeries were required for 86 patients (5.8%) and the overall mortality rate reached 0.7% (10 cases in total). These pooled radiographic corrections are clinically relevant to wheelchair sitting balance and overall spino-pelvic alignment in NMS, supporting pre-operative counseling about the functional value of pelvic fixation.

Conclusions

Pelvic fixation provides effective deformity and pelvic obliquity correction with acceptable complication rates. These pooled data offer benchmark reference values to guide surgical counseling and trial design.