Evaluation of pelvic fixation in neuromuscular scoliosis: a retrospective study in 55 patients.

The literature has described different indications for pelvic fixation in neuromuscular scoliosis. We retrospectively evaluated changes in pelvic obliquity for a minimum of two years among three groups: group I (initial pelvic obliquity >15 degrees; with pelvic fixation), group II (initial pelvic obliquity >15 degrees; without pelvic fixation), and group III (initial pelvic obliquity <15 degrees; without pelvic fixation). We used iliac screws for pelvic fixation in group I. There was significant postoperative improvement (p < 0.0001) in Cobb's angle and pelvic obliquity. There was no significant loss of correction in Cobb's angle, thoracic kyphosis, and lumbar lordosis among all three groups; however, group II showed significant correction loss in pelvic obliquity compared to groups I and III at final follow-up (p < 0.0001). Our results indicate that patients who have pelvic obliquity >15 degrees require pelvic fixation to maintain the correction and balance over time while obliquity <15 degrees does not require pelvic fixation.