Long-term outcomes of the spinopelvic "reverse T-construct" combined with magnetically controlled growing rods for the treatment of neuromuscular scoliosis.

OBJECTIVE

Neuromuscular scoliosis (NMS) typically develops at an early age, leading to postural instability and cardiopulmonary complications due to spinal deformity and pelvic obliquity. Long-term comfort requires surgical intervention to restore spino-pelvic balance. This study aimed to report the long-term outcomes of a reverse T-construct pelvic fixation technique combined with magnetically controlled growing rods for the pediatric NMS treatment.

METHODS

Between 2016 and 2023, 34 patients with NMS underwent surgery using the reverse T-construct using two sacral screws and two iliac screws connected by a horizontal rod, linked to magnetically controlled growing rods. Clinical and radiographic outcomes were evaluated with a minimum follow-up of two years.

RESULTS

The mean age at surgery was 10 ± 1.7 years. The mean preoperative Cobb angle of 69.9° ± 20.3, was decreased to 35.6° ± 21.4 postoperatively. At the last follow-up, the average correction loss was 8.9° ± 17 (p < 0.05). The mean preoperative pelvic obliquity of 14.8° ± 11.1, improved to 3.3° ± 3.7 postoperatively, with an average correction loss of 1.5° ± 3.5° at the last follow-up (p < 0.05). Two postoperative infections and two cutaneous complications were reported. Eight mechanical complications were recorded: one rod fracture, one migration of a rib hook, and six related to pelvic fixation.

CONCLUSIONS

The reverse T-construct with magnetically controlled growing rods demonstrated satisfying long-term correction of spinal alignment and pelvic obliquity. This technique offers stable pelvic balance, early mobilization, with a low complication rate, making it a viable alternative for managing patients NMS.