Pelvic Fixation in Spine Surgery

Moshirfar, Ali; Rand, Frank; Sponseller, Paul D.; Parazin, Stephen; Khanna, A. Jay; Kebaish, Khaled M.; Stinson, John T.; Riley, Lee H.

doi:10.2106/jbjs.e.00453

Cited by 131 publications

(81 citation statements)

References 51 publications

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“…However, dual iliac screw technique increases the difficulty of screw-rod connection and medical cost in the clinical scenario. Moreover, single iliac screw technique is still commonly used in the lumbo-iliac reconstruction surgery [1,2]. Therefore, further clinical and biomechanical studies are needed to determine which types of lumbosacral instabilities require single-and which ones require dual iliac screw fixation technique.…”

Section: Discussionmentioning

confidence: 99%

“…Iliac screw technique is a common technique adopted in treating certain typical conditions requiring long segment fixation such as in the correction of neuromuscular and adult scoliosis, reduction of high-grade spondylolisthesis, sacral fractures, and surgical treatment of sacral tumors requiring sacrectomy [1][2][3][4][5][6][7][8]. Although iliac screw fixation provides a solid foundation to restore spinal balance and to stabilize the lumbosacral junction, high rate of implant failure including screw loosening and breakage has also been reported, especially in patients with bilateral single iliac screw fixation [2,3,5,8].…”

Section: Introductionmentioning

confidence: 99%

“…Miller et al [11] have reported a high rate of penetration (25%) of the iliac screws into the ilium and acetabulum during insertion from PSIS to AIIS, especially when the screw insertion depth exceeds 100 mm. Therefore, the use of iliac screws of length ranging from 70 mm (exceeding the level of GSN) to 90 mm has become a clinical consensus [1,11].…”

Section: Introductionmentioning

confidence: 99%

“…Compared with the Galveston technique, iliac screw fixation technique can provide easier manipulation along with higher fixation strength [1,13]. Biomechanical studies have further confirmed that increasing the length or diameter of the iliac screws can significantly enhance the iliac fixation strength [12,14].…”

Section: Introductionmentioning

confidence: 99%

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

Zhuang

Zheng

et al. 2010

Eur Spine J

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Zhuang

Zheng

et al. 2010

Eur Spine J

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“…5,13,19,26,29,30,34,40 According to a recent study, approximately 15% of ambulatory patients undergoing pelvic fixation with iliac screws below an extensive thoracolumbar fusion will develop pseudarthrosis with broken implants. 11 Nonunion in the lumbosacral region will occur in approximately onethird of such cases, with an estimated incidence of 6.4%.…”

Section: 14mentioning

confidence: 99%

Combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability

Mattei

Fassett²

2013

SPI

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Lumbosacropelvic pseudarthrosis after long spinal fusions for treatment of adult degenerative scoliosis remains a challenging condition. Moreover, although pelvic fixation with iliac screws is widely used in deformity surgery to provide a biomechanically strong distal anchor for long thoracolumbar constructs, there are very few options available after failed pelvic fixation with iliac screws. The authors conducted a retrospective review of the surgical charts and imaging findings of patients subjected to revision surgery for lumbosacropelvic pseudarthrosis from August 2011 to August 2012. This review identified 5 patients in whom a salvage technique combining both S-1 and S-2 sacral alar-iliac (SAI) screws had been performed. In this technical note, the authors present a detailed anatomical discussion and an appraisal of the sequential intraoperative steps of this new technique involving a combination of S-1 and S-2 SAI screws. The discussion is illustrated with a surgical case in which this technique was used to treat a patient with pseudarthrosis that had developed after fixation with classic iliac screws. In conclusion, although S-2 SAI screws have previously been reported as an interesting alternative to classic iliac wing screws, this report is the first on the use of combined S-1 and S-2 SAI screws for pelvic fixation as a salvage technique for lumbosacropelvic instability. According to the reported experience, this technique provides a biomechanically robust construct for definitive pelvic fixation during revision surgeries in the challenging scenarios of pseudarthrosis and instability of the lumbosacropelvic region.

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Sacrum Anatomy: New Concepts

Gille

Chevillotte

2019

Spinal Anatomy

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Pelvic Fixation in Spine Surgery

Cited by 131 publications

References 51 publications

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

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

Combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability

Sacrum Anatomy: New Concepts

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