Percutaneous Sacroiliac Screw Placement

Wang, Junqiang; Wang, Yu; Feng, Y. T.; Han, Wenling; Su, Yung‐Yeh; Liu, Wenyong; Wei-jun, Zhang; Wu, Xinbao; Wang, Manyi; Fan, Yubo

doi:10.4103/0366-6999.217080

Cited by 81 publications

(63 citation statements)

References 21 publications

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“…These complications can be caused by K-wire or screw mal-positioning during insertion. The rate of mal-positioning is still reported to be approximately 5% [ 3 , 4 ]. Nevertheless, the advantages over open techniques are obvious and some authors consider percutaneous SI-screw fixation to be the only minimally invasive technique to stabilize the posterior pelvic ring [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation—A 15-Year Retrospective Analysis on over 640 Screws

Hartensuer

Lodde

Keller

et al. 2020

JCM

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Background: Minimally invasive sacroiliac-screw (SI-screw) fixation of the pelvis is used in energy trauma (Arbeitsgemeinschaft für Osteosynthesefragen (AO) classified) and fragility fractures (Fragility Fracture of the Pelvis (FFP) classified). However, available clinical data are based on small case series and biomechanical data seem to be contradictory. Methods: The present single center retrospective cohort study investigated percutaneous SI-screw fixation and augmentation over 15 years. Groups were compared concerning the general epidemiological data, mobilization, complication rates, duration of stay, and safety of SI-screw insertion. Multivariable analyses were performed using logistic regression. Results: Between 2005 and March 2020, 448 patients with 642 inserted SI-screws were identified. Iatrogenic neurological impairment was documented in 2.47% and correlated with screw misplacement. There was an increased complication risk in patients with AO type C over patients with AO type B and in FFP II over FFP III/IV patients. Cement-augmented FFP patients showed a 25% reduced stay in hospital and a reduced complication risk. Cement-associated complications were seen in 22% without correlation to neurologic impairment. Conclusions: The present study confirms the safety and usability of percutaneous SI-screw fixation, despite specific risks. Cement augmentation seems to reduce the complication risk in FFP patients and shorten hospital stay for some reasons, without increased specific complications or correlated neurological impairment.

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Section: Introductionmentioning

confidence: 99%

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation—A 15-Year Retrospective Analysis on over 640 Screws

Hartensuer

Lodde

Keller

et al. 2020

JCM

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“…Our guide needle insertion time was shorter when compared with the conclusions of previous studies. [ 18 19 ] Nevertheless, no significant difference was observed concerning the accuracy of screw placement and blood loss. Moreover, no screw loosening was found during the follow up period in this case.…”

Section: Discussionmentioning

confidence: 98%

“…[ 15 16 ] Many strategies have developed to facilitate PPSs insertion for PRI, such as a robot-assisted navigation system, a computed tomography (CT)-based navigation and a fluoroscopic-based navigation. [ 1 17 18 19 20 ] Nevertheless, there are still occasional surgical complications, such as neurovascular damage and wound infections. Consequently, the purpose of the present study is to evaluate the accuracy, effectiveness, and safety of screw view model of navigation (SVMN) guided PPSs insertion for the treatment of lateral compression PRI.…”

Section: Introductionmentioning

confidence: 99%

A screw view model of navigation guided minimal invasive percutaneous pelvic screws insertion for lateral compression pelvic ring injuries

Yuan¹,

Huang

Zheng³

et al. 2020

Medicine

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Rationale: The objective of the present study was to evaluate the accuracy, effectiveness, and safety of screw view model of navigation (SVMN) guided minimal invasive percutaneous pelvic screws (PPSs) insertion for lateral compression pelvic ring injuries (PRI). Patient concerns: A female patient experienced a high falling injury, and presented with pain, swelling, deformity, and movement limitation of the left hip for 3 hours. Diagnoses: She was diagnosed with pelvic fractures, left iliac fracture, left pubic branch fracture, left ischial branch fracture, and lumbar transverse process fracture. Interventions: We used a SVMN technique to guide PPSs insertion, including a percutaneous anterior inferior iliac spine screw, a percutaneous iliac screw (PIS), and a percutaneous sacroiliac screw (PSIS). Outcomes: In total, 3 PPSs were inserted and all were presented with excellent position postoperatively. The designing time of all screws was 11.7 minutes, the time of all guide needles insertion was 18.1 minutes, the time of all screws insertion was 32.8 minutes, blood loss was 21 mL, and the time of radiation exposure lasted 7.2 minutes. Moreover, surgical complications, including neurovascular compromise, wound infection, fracture nonunion, and screw loosening, were not observed during the 12 months follow up visit. Lessons: SVMN technique guided PPSs insertion is an effective and safety approach for the treatment of PRI in selected patients. Besides, it is necessary for surgeons to master the rationale of computer navigation, to familiar with the anatomy of pelvis and to select suitable patients.

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“…The excellent and good rate of screw placement was 100%. The fluoroscopy time after pelvic reduction was 7 (7,9) seconds. The operation time after reduction of the pelvis was 29 (27,33).…”

Section: Resultsmentioning

confidence: 99%

“…Incorrect placement of SI screws may result in implant-related and neurovascular complications [6], therefore it's urgent to find a safe and effective method to solve this problem. TiRobot™ is an orthopaedic surgery robot which can be used for SI screw fixation which has shown accuracy in cadaver and cohort studies [7]. This study is designed to analyse of the accuracy of S2 screws using robot-assisted navigation.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Analysis of S2 Iliosacral Screw Fixation Using Robot-Assisted Navigation for Unstable Pelvic Injuries and Sacral Dysmorphism: a Report of 16 Cases

Wang¹,

Han²,

Zhang³

et al.

EPiC Series in Health Sciences

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Objective The second sacral segment iliosacral screw (S2 screw) insertion is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot™ is an orthopedic surgery robot which can be used for S2 screw fixation. We carried out a retrospective analysis of the accuracy of S2 screws using robot-assisted navigation.Methods A retrospective analysis of 16 patients admitted and managed by S2 screw fixation for unstable pelvic fractures was carried out for evaluation of its efficacy and safety. all patients with pelvic ring disruptions and sacral dysmorphism were evaluated radiographically and S2 screws were placed using a robot-assisted navigation technique. Screw position was assessed and classified using postoperative computed tomography. Fisher’s exact probabilities test was used to analyse the screws’ positions. Surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction were also assessed.Results The excellent and good rate of screw placement was 100%. The fluoroscopy time after pelvic reduction was 7 (7, 9) seconds. The operation time after reduction of the pelvis was 29 (27,33). Time for guide wire insertion was 2.0 (2, 2) minutes. The number of guide wire attempts was 0.0 (0, 0). No postoperative complications or revisions were reported.Conclusion S2 iliosacral screws can be safely and accurately accomplished using a robot-assisted navigation technique in patients with unstable posterior pelvic ring disruptions and sacral dysmorphism.

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Percutaneous Sacroiliac Screw Placement

Cited by 81 publications

References 21 publications

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation—A 15-Year Retrospective Analysis on over 640 Screws

Safety, Effect and Feasibility of Percutaneous SI-Screw with and without Augmentation—A 15-Year Retrospective Analysis on over 640 Screws

A screw view model of navigation guided minimal invasive percutaneous pelvic screws insertion for lateral compression pelvic ring injuries

A Retrospective Analysis of S2 Iliosacral Screw Fixation Using Robot-Assisted Navigation for Unstable Pelvic Injuries and Sacral Dysmorphism: a Report of 16 Cases

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