Bilateral sacroiliac luxation fixation using a single transiliosacral pin: surgical technique and clinical outcomes in eight cats

Abstract

This technique offers a simple, safe, repeatable and affordable technique for treating bilateral sacroiliac luxations in the cat without the aid of fluoroscopy. The procedure can be performed using surgical tools and inventory readily available in general small animal practices.

Single Transsacral Screw and Nut Stabilization of Bilateral Sacroiliac Luxation in 20 Cats

“…Several surgical techniques have been described in cats including lag or positional screw stabilization, 2,6-8 tension band technique, 9 transiliac pin/bolt/screw 10 and trans-iliosacral pin. 11 The preferred method for stabilizing sacroiliac luxations in small animals is lag screw placement, 12 assuming that the screw that is used is the largest possible and purchases more than 60% of the width of the sacral body to limit screw loosening. 7 However, in bilateral sacroiliac luxation using these guidelines can be challenging due to the narrow sacral safe corridor.…”

Defining a safe corridor for trans‐iliac pin placement in cats

“…10,23 Another potential advantage is the shorter anaesthetic time required for placement. 14,15 Although an SI lag screw has shown increased friction in the SI joint, providing a more stable construct, Yap et al 14 hypothesised that iliac wing compression achieved by trans-iliac implants is enough to reduce hemipelvis displacement based on their reported clinical cases. 14,15,24 Trans-iliac pinning, however, is not without risks, with pin loosening and/or soft tissue focal irritation reported in dogs 4-6 weeks postoperatively.…”

“…14,15 Although an SI lag screw has shown increased friction in the SI joint, providing a more stable construct, Yap et al 14 hypothesised that iliac wing compression achieved by trans-iliac implants is enough to reduce hemipelvis displacement based on their reported clinical cases. 14,15,24 Trans-iliac pinning, however, is not without risks, with pin loosening and/or soft tissue focal irritation reported in dogs 4-6 weeks postoperatively. 24 Trans-iliac pin bending has also been reported in one cat by Yap et al 14 Overall, clinical reports appear to support trans-iliac pinning as an alternative to trans-iliosacral lag screw.…”

“…Parslow and Simpson 15 described a stabilisation technique using trans-iliosacral pinning for bilateral SI luxation in cats that could be an alternative to the trigonometric method described in this article. Pratesi et al 13 also proposed a single screw placement to stabilise bilateral luxations, which may be simpler, have a lower risk and technical difficult than placing bilateral SI lag screws, although both Parslow and Simpson 15 and Pratesi et al 13 require a C-shaped aiming device. Clearly, if an SI screw was placed unilaterally followed by a trans-iliac pin to facilitate stability of the contralateral luxation, the theoretical safe corridor would be entirely dependent on a highly accurate reduction of the lag screw-stabilised SI fixation side, which is not always achieved.…”

“…[11][12][13] Trans-iliac pin stabilisation of SI luxation has also been described as the sole method of stabilisation in cats by Yap et al, 14 in which a pin is passed through the iliac wing either caudal to or through the dorsal spinal process of L7 (Figure 1), and as a bilateral fixation method using a single trans-iliosacral pin by Parslow and Simpson. 15 Trans-iliac pins have also been utilised as an indirect method of contralateral stabilisation when combined with screw fixation and trans-sacral pins on the ipsilateral side. 16 Placement of lag screws through the ilium has been well described for both the canine and feline sacrum, including the anatomical differences, allowing for reliable and accurate screw positioning.…”