• Arnaud Dubory, Manon Bachy, Houssam Bouloussa, Aurélien Courvoisier, Baptiste Morel, and Raphaël Vialle.
• Department of Paediatric Orthopaedics, Armand Trousseau Hospital, Université Pierre et Marie Curie-Paris6, 26, avenue du Docteur Arnold Netter, 75571, Paris Cedex 12, France.
• Eur Spine J. 2015 Nov 1; 24 (11): 2580-7.

PurposeThe primary goal of curve correction in neuromuscular patients is to restore coronal and sagittal trunk balance, including the pelvis, to maximize sitting balance. For several years, it has been a common practice to inject polymeric cement into osteoporotic bone through specially designed, perforated pedicle screws in an effort to enhance screw stability. Therefore, we started using the association of a spinopelvic fixation with S1 pedicle screw augmentation, using bisphenol-a-glycidyl dimethacrylate composite resin in neuromuscular patients with pelvic obliquity, technique in neuromuscular patients to improve pedicle screw stability of our pelvic construct.MethodsTen patients undergoing spinopelvic fixation for a neuromuscular spinal deformity were enrolled in the study. Clinical and radiographic data were analyzed and presented. Minimal follow-up took place at 6 months to assess early complications.ResultsFive patients were diagnosed with spastic quadriplegia secondary to cerebral palsy, four had Duchenne's muscular dystrophy, and one had a T5-level traumatic flaccid paraplegia. Preoperative PO ranged from 8° to 34° (mean 19.16°). Postoperative PO ranged from 0° to 6.3° (mean 1.6°). After surgery, all patients returned to a full-time sitting position between days 5 and 12 without the need for additional bracing. No mechanical failure of the construct was noted during follow-up.ConclusionsWe used sacral pedicle screw augmentation as a reliable tool to strengthen spinopelvic fixation in neuromuscular scoliosis without increasing the intraoperative morbidity. In our practice, sacral screw augmentation can definitely enhance PO correction obtained by a posterior procedure.

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