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Related Experiment Video

Updated: Jan 3, 2026

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Pelvic Obliquity Correction in Distraction-Based Growth Friendly Implants.

Mathew Schur1, Lindsay M Andras1, Rajan Murgai1

  • 1Children's Orthopaedic Center, Children's Hospital Los Angeles, 4650 Sunset Blvd, Los Angeles, CA 90027, USA.

Spine Deformity
|November 17, 2019
PubMed
Summary
This summary is machine-generated.

For early-onset scoliosis treated with distraction-based implants, pelvic fixation using screws showed better correction of pelvic obliquity compared to S hooks. Complication rates were lower with screws, though not statistically significant.

Keywords:
ComplicationsDistraction-based growth friendly implantsEarly onset scoliosisLumbar lordosisPelvic obliquity

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Area of Science:

  • Pediatric Orthopedics
  • Spinal Surgery
  • Scoliosis Treatment

Background:

  • Distraction-based growing rod systems are used for early-onset scoliosis (EOS).
  • Pelvic fixation is crucial for these systems, with screws and hooks being common methods.
  • Comparative data on the efficacy and safety of different pelvic fixation techniques are limited.

Purpose of the Study:

  • To compare radiographic outcomes and complication rates of distraction-based implants with either screw-based or hook-based pelvic fixation.
  • To evaluate the effectiveness of sacral-alar-iliac (SAI) screws or iliac screws versus S hook iliac fixation in EOS patients.

Main Methods:

  • Multicenter retrospective review of 153 EOS patients treated with distraction-based implants and pelvic fixation (2000-2013).
  • Patients were divided into two groups: screw fixation (SAI or iliac screws) and S hook fixation.
  • Exclusion criteria included index instrumentation age ≥10 years and follow-up <2 years.

Main Results:

  • Screw fixation group (42 patients) showed significantly greater correction of pelvic obliquity (>20°) compared to the S hook group (111 patients) (26° vs. 17°, p = .039).
  • No significant differences were observed in T1-S1 length change (40 vs. 39 mm, p = .89) or Cobb angle correction (30° vs. 24°, p = .24).
  • Total complication rates were 14% for screws and 25% for S hooks (p = .25), with common complications including device migration, implant failure, and prominence.

Conclusions:

  • Pelvic fixation with screws in distraction-based growing constructs offers superior correction of pelvic obliquity compared to S hooks.
  • While not statistically significant, S hooks were associated with a nearly twofold higher complication rate than screws.
  • Screw-based pelvic fixation may be a preferable option for managing pelvic obliquity in EOS treated with growing rods.