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目的:探讨在严重脊柱侧后凸畸形患者后路矫形术中，采取单侧或双侧双枚经第2骶椎骶髂螺钉（second sacral alar-iliac，S2AI）固定技术的适应证，并且探究此技术的可行性并评估其临床疗效及并发症情况。方法:收集2014年1月至2019年12月共11例应用双S2AI固定技术进行后路脊柱矫形融合术的患者的病例资料，男5例，女6例；年龄（28.8±16.8）岁（范围12~60岁）。所有患者术前、术后均拍摄全脊柱正位、侧位X线片以及全脊柱CT，根据Gertzbein & Robbins评分法评价螺钉置入的精确性，测量术前、术后以及末次随访时的侧凸Cobb角，冠状面平衡（coronal balance，CB），脊柱骨盆倾斜角（spinal pelvic obliquity，SPO），局部后凸角（regional kyphosis，RK），探究描述患者采取双S2AI固定技术的原因，并且比较患者术前、术后及末次随访时的影像学差异及疗效评价差异。结果:11例中9例患严重脊柱侧后凸畸形伴骨盆倾斜，另外2例为既往脊柱术后医源性后凸畸形患者。11例患者术后随访（11.6±8.5）个月（范围6~30个月）。7例患者单侧置入双S2AI螺钉，4例双侧置入双S2AI螺钉，3例患者联合置入髂骨螺钉（iliac screw，IS）或髂骶螺钉（iliac sacral screw，ISS）。共置入35枚螺钉，术后CT示30枚为A级，5枚为B级，螺钉位置均良好，术前侧凸Cobb角87.2°（5.3°，150.5°），CB为13.6 mm（2.2 mm，91.7 mm），SPO为30.7°（0.6°，57.5°），RK为27.6°（14.2°，128.3°）；术后即刻侧凸Cobb角25.4°（4.9°，84.1°），CB为8.2 mm（3.1 mm，63.2 mm），SPO为12.1°（0.9°，27.0°），RK为8.4°（4.1°，57.8°）。术后矢状面和冠状面的失衡均得到改善；末次随访矢状面以及冠状面的形态有较好的维持。11例术中均无SEP以及MEP信号改变或者丢失，随访中1例患者出现伤口深部感染，伤口愈合不良。余患者术后以及随访过程中无明显断棒断钉，螺钉松动等。结论:需行骨盆固定的患者若存在以下三种情况：①胸腰椎大段椎体无法置钉，但需保持植入物密度；②行序贯矫形的手术策略时单枚S2AI螺钉的置入无法有效的分散腰骶部的应力；③行复杂腰骶部畸形翻修手术时需要获取牢固内固定时，运用同侧双枚S2AI固定技术是一种好的选择，可提供坚强固定，有效地矫正畸形，并且并发症发生率较低。“,”Objective:To investigate when to apply unilateral/bilateral dual second sacral alar-iliac technique for spinoplevic fixation in patients with severe kyphoscoliosis, and evaluate the feasibilityand clinical outcome.Methods:11patients (5 males and 6 females) applying unilateral/bilateral dual second sacral alar-iliac screws from January 2014 to December 2019 were retrospectively reviewed. The average age of the cohort was 28.8±16.8 years (range, 18-60 years). All patients were taken anteroposterior and lateral radiographs of the entire spine. Cobb's angle, coronal balance (CB), spinal pievic obliquity (SPO), regional kyphosis (RK) were recorded at pre-operation, post-operation and last follow up.Results:In these 11 patients, 9 patients suffered from severe scoliosis or kyphoscoliosis, 2 patients suffered from severe kyphosis and had underwent multiple operations. The average follow-up period was 11.6±8.5 months. 7 patients had unilateral dual S2AI screws placement and 4 patients had bilateral dual S2AI screws placement. Three patients had iliac screws or iliac sacral screws placement. The pre-operative Cobb angles were 87.2° (5.3°, 150.5°), CB were 13.6 mm (2.2 mm, 91.7mm), SPO were 30.7° (0.6°, 57.5°), RK were 27.6° (14.2°, 128.3°). The post-operative Cobb angles were 25.4° (4.9°, 84.1°), CB were 8.2 mm (3.1 mm, 63.2 mm), SPO were 12.1° (0.9°, 27.0°), RK were 8.4° (4.1°, 57.8°),showing significant improvement compared to pre-operation. In these patients, one patient had deep infection and recovered with debridement surgery, other patients didn't have any complications.Conclusion:Patients who need pelvic fixation have the following three conditions: the large segment of the thoracolumbarvertebral bodies cannot provide enough place for screws, but the implant density should be maintained; the placement of a single S2AI screw could not effectively disperse the stress in the lumbosacral region during the sequential correction strategy; when a firm internal fixation is needed for complex revision surgery. Unilateral/bilateral dual second sacral alar-iliac technique could produce excellent correction of kyphoscoliosis and obtain satisfied clinical outcomes with fewer complications.