Biomechanical advantages of dual over single iliac screws in lumbo-iliac fixation construct

Yu, Bo; Zhuang, Xiaoxi; Zheng, Zhaomin; Li, Zemin; Wang, Tai-Ping; Lu, William W.

doi:10.1007/s00586-010-1343-8

Cited by 76 publications

(49 citation statements)

References 16 publications

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“…22 Our results show that both interbody fusions with cages and use of a rod with sublaminar hooks decrease the incidence of failures. These satisfactory results are attributable to the fact that both interbody cages and rods with compression hooks reduce the significant flexion stresses produced on the rods in the lumbosacral spine.…”

Section: Discussionmentioning

confidence: 54%

“…19,21,22 In a previous study that presents incidence of implant failures similar to ours, 14 the incidence of failures of implants using one or two bilateral iliac screws for long fusions in patients with scoliosis of neurological etiology was evaluated, determining that the use of two bilateral iliac screws significantly reduced the number of instrumentation failures. These results do not match those of our study, in which similar percentages of complications were presented using one, two, or more iliac screws.…”

Section: Discussionmentioning

confidence: 79%

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Resultado a largo plazo de las fusiones largas espinopelvicas en escoliosis: importancia de la edad, la capacidad de marcha y el tipo de fijación ilíaca

et al. 2013

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Objective: To determine the factors that influence lumbosacral instrumentation failures following spinopelvic fusions. Methods: A retrospective study of patients diagnosed with scoliosis who underwent spinopelvic fusion via posterior, from T2 or T3 proximally to iliac crest, using pedicle and iliac screws. Instrumentation failures were analyzed, and the association of this complication with different parameters was studied. Results: We present 44 patients, with an average age of 24 years, with different etiologies. The mean value of the largest preoperative major curve was 74.2°, and in the final review, it was 67%. The anterior-posterior imbalance, pelvic tilt, thoracic kyphosis, lumbar lordosis and lateral imbalance were significantly improved in the final review. There were instrumentation failures in 41% cases, all at the lumbosacral level. A significant association was found between increased instrumentation failures in patients over 17 years and in patients with independent walking ability. In 24 patients, a bilateral single iliac screw was used and in 20 patients, two or more screws were used. Both groups had a similar incidence of failures. In the group with two or more screws, only rod breakages occurred, without detachment or screw lysis. There was lower instrumentation failure incidence in the patients who underwent L3-S1 interbody fusion or a third rod attached with sublaminar compression hooks. Conclusions: This series had 41% instrumentation failures, all located at lumbosacral level. There were significant more instrumentation failures in patients with independent walking ability and those aged over 17 years. There was lower instrumentation failure incidence in the patients who underwent L3-S1 interbody fusion or a third rod attached with sublaminar compression hooks.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 79%

Resultado a largo plazo de las fusiones largas espinopelvicas en escoliosis: importancia de la edad, la capacidad de marcha y el tipo de fijación ilíaca

et al. 2013

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“…However, the use of iliac screws with long length and thick diameter could be an issue in young patients with thick iliac cortex width. The virtual screws used in the current study are long and have large diameters and may not be smaller than clinically utilised screws in most patients [16,17]. The current pass ratio of iliac screws with 100 mm length and 10 mm diameter is about 75 % in a small entry point zone, and the pass ratio of shorter screws with 80 mm length and same diameter is greater than 90 % within the same entry zone.…”

Section: Discussionmentioning

confidence: 85%

“…In terms of the biomechanical properties, the dual iliac screw was stiffer in compression and torsion than the single screw [17]. To have two iliac screws in one side, the first screw should be located more distally in the current entry zone.…”

Section: Discussionmentioning

confidence: 98%

Entry zone of iliac screw fixation to maintain proper entry width and screw length

2015

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“…the two screws can be placed into the same -lower -or into two different -upper and lower -iliac columns). 25 Further modification of SPF was published as four rod (FRR) or double-rod double iliac screw (DDS) reconstruction technique (Figure 2/D). [26][27][28][29] The biomechanical analyses showed that the additional lumbopelvic rods could increase the rigidity of the construct.…”

Section: Reconstruction Of the Biomechanicsmentioning

confidence: 99%

Surgical resection and reconstruction after resection of tumors involving the sacropelvic region

Varga

Szövérfi

Lazáry

2014

Neurological Research

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ObjectivesSurgical management of the tumors in the sacropelvic region is a challenging field of spine surgery because of the complex local anatomy and biomechanics. Recent development in anesthesia and intensive care has allowed us to perform extended surgeries focused on the en bloc resection of sacropelvic tumors. Various techniques for the resection and for the reconstruction were published in the last decade. MethodsSacropelvic tumor resection techniques and methods for the biomechanical and soft-tissue reconstruction are reviewed in this paper. ResultsLiterature data is based on case reports and case-series. Several different techniques were developed for the lumbopelvic stabilization after sacropelvic tumor resection according to three different reconstruction principles (spinopelvic fixation, posterior pelvic ring fixation, anterior spinal column fixation); however, long term follow up data and comparative studies of the different techniques are still missing. Soft-tissue reconstruction can be performed according to an algorithm depending on the surgical approach, but relatively high complication rates are reported with all reconstruction strategies. The clinical outcome of such surgeries should ideally be evaluated in three dimensions; surgical-, oncological-, and functional outcomes. The last, and most important step of the presurgical planning procedure is a careful presentation of the surgical goals and risks to the patient, who must provide a fully informed consent before surgery can proceed. Discussion Sacropelvic tumors are rare conditions. In the last decade, growing evidence was published on resection and reconstruction techniques for these tumors; however, experience at most medical centers is limited by the low case-number. Formation of international expert groups and initiation of multicenter studies is strongly encouraged to produce a high level of evidence in this special field of spine surgery.

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Biomechanical advantages of dual over single iliac screws in lumbo-iliac fixation construct

Abstract: The development of iliac screws has provided a markedly easier way for spino-pelvic instrumentation than the classical Galveston technique.

Cited by 76 publications

References 16 publications

Resultado a largo plazo de las fusiones largas espinopelvicas en escoliosis: importancia de la edad, la capacidad de marcha y el tipo de fijación ilíaca

Resultado a largo plazo de las fusiones largas espinopelvicas en escoliosis: importancia de la edad, la capacidad de marcha y el tipo de fijación ilíaca

Entry zone of iliac screw fixation to maintain proper entry width and screw length

Surgical resection and reconstruction after resection of tumors involving the sacropelvic region

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