Fluoroscopy-Based Multiplanar Image Guidance for Insertion of Sacroiliac Screws

Af, Hinsche; Pv, Giannoudis; Rm, Smith

doi:10.1097/00003086-200202000-00014

Cited by 108 publications

(58 citation statements)

References 16 publications

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“…Our study demonstrates a misplacement rate of 8%, which is in line with previous findings [12][13][14]. However, in comparison to other surgical procedures this misplacement rate is still unacceptably high.…”

Section: Discussionsupporting

confidence: 92%

Factors influencing the accuracy of iliosacral screw placement in trauma patients

Großterlinden

Rueger

Catalá-Lehnen

et al. 2010

International Orthopaedics (SICOT)

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Correct placement of iliosacral screws remains a surgical challenge. The aim of this retrospective study was to identify parameters which impact the accuracy of this technically demanding procedure. Eighty-two patients with vertically unstable pelvic injuries treated with a total of 147 iliosacral screws were included. Assessment of postoperative CT scans revealed screw misplacement in 13 cases (8%), of which six occurred following insertion of two unilateral screws into S1. Six screw misplacements occurred in patients with dislocation injuries of the posterior pelvis. Comparison of a navigated and the standard technique revealed a decreased screw misplacement rate in the navigated group (15% standard vs. 3% navigation, p<0.05). In addition, the malposition rate was influenced by the surgeon's individual experience (20% for low vs. 3.9% for high volume surgeons, p<0.05). Overall, the accuracy of iliosacral screw placement depends on the number of screws inserted into S1 and the extent of dislocation. In experienced hands, the use of navigation represents a helpful tool to improve the placement accuracy.

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Section: Discussionsupporting

confidence: 92%

Factors influencing the accuracy of iliosacral screw placement in trauma patients

Großterlinden

Rueger

Catalá-Lehnen

et al. 2010

International Orthopaedics (SICOT)

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“…Screw malposition rates with fluoroscopic guidance have been reported to range from 2% to 15% [13,28], with an incidence of neurologic injury between 0.5% and 7.7% [32]. Accuracy of computer-guided transiliosacral screw implantation has been reported to be sufficiently effective and safe in preclinical work [4,31] to warrant clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment of unstable pelvic ring fractures by transiliosacral screw fixation after accurate reduction has gained general acceptance to rigidly stabilize pelvic fractures and posterior sacroiliac ligamentous injuries [6,13,15,16,19,20,22,31]. Use of a percutaneous method avoids the high rate of wound necrosis and infection associated with open procedures [15,19].…”

Section: Introductionmentioning

confidence: 99%

“…To achieve proper screw fixation, various authors have used fluoroscopy [9,20], computed tomography (CT) [9,12,17], fluoroscopic CT, and computer-assisted techniques [4,11,31]. Conventional fluoroscopy is the current standard for intraoperative observation [6,12,13,15,19,20]. Lateral sacral images in combination with the anteroposterior, inlet, and outlet views are necessary.…”

Section: Introductionmentioning

confidence: 99%

“…Screw malposition rates with fluoroscopic guidance have been reported to range from 2% to 15% [13,28], with an incidence of neurologic injury between 0.5% and 7.7% [32]. Malposition of the screw by as little as 4°can cause damage to neurovascular structures [28].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Zwingmann¹,

Konrad²,

Kotter³

et al. 2009

Clinical Orthopaedics &Amp; Related Research

154

110

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Insertion of percutaneous iliosacral screws with fluoroscopic guidance is associated with a relatively high screw malposition rate and long radiation exposure. We asked whether radiation exposure was reduced and screw position improved in patients having percutaneous iliosacral screw insertion using computer-assisted navigation compared with patients having conventional fluoroscopic screw placement. We inserted 26 screws in 24 patients using the navigation system and 35 screws in 32 patients using the conventional fluoroscopic technique. Two subgroups were analyzed, one in which only one iliosacral screw was placed and another with additional use of an external fixator. We determined screw positions by computed tomography and compared operation time, radiation exposure, and screw position. We observed no difference in operative times. Radiation exposure was reduced for the patients and operating room personnel with computer assistance. The postoperative computed tomography scan showed better screw position and fewer malpositioned screws in the three-dimensional navigated groups. Computer navigation reduced malposition rate and radiation exposure. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Navigation‐aided visualization of lumbosacral nerves for anterior sacroiliac plate fixation: a case report

Takao

Nishii

Sakai

et al. 2013

Robotics Computer Surgery

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Fluoroscopy-Based Multiplanar Image Guidance for Insertion of Sacroiliac Screws

Cited by 108 publications

References 16 publications

Factors influencing the accuracy of iliosacral screw placement in trauma patients

Factors influencing the accuracy of iliosacral screw placement in trauma patients

Computer-navigated Iliosacral Screw Insertion Reduces Malposition Rate and Radiation Exposure

Navigation‐aided visualization of lumbosacral nerves for anterior sacroiliac plate fixation: a case report

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