Percutaneous Sacroiliac Screw Technique

Tidwell, John Edgar; Cho, Rosa; Reid, J. Spence; Boateng, Henry A.; Copeland, Carol E.; Sirlin, Edward A.

doi:10.1097/bot.0000000000000606

Cited by 24 publications

(20 citation statements)

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“…Several options can be used for stabilizing the posterior pelvic ring, such as a transiliac internal fixator, lumbopelvic fixation, and percutaneous sacroiliac screw fixation [ 5 – 7 ]. In recent years, sacroiliac screw fixation has been considered the workhorse of sacral fractures involved in the areas of zone I and II [ 8 ]. However, appropriate S1 corridors in 66% of female and 63% of male patients were reported, with appropriate S2 corridors in all female and 87% of male patients included in the investigation [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients

Liu

Jin

et al. 2021

Med Sci Monit

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Background This retrospective study from a single center aimed to compare patient outcomes following TiRobot-assisted sacroiliac screw fixation and bone grafting with traditional screw fixation without bone grafting in 33 patients with unstable osteoporotic sacral fracture (UOSF). Material/Methods Patients with UOSF were included and divided into 2 groups: a TiRobot-assisted surgical group with 18 patients (robot-aided sacroiliac screw fixation and bone grafting) and a standard surgical group with 15 patients (free-hand screw fixation without bone grafting). T values of bone mineral density (BMD) ≤-2.5 standard deviation (SD) were diagnosed as osteoporosis. Screw positioning and fracture healing time were evaluated. Functional outcomes were investigated at the final follow-up. Results There were no statistically significant differences in screw positioning; however, there were satisfactory positioning rates in 94.4% (17/18) of patients in the TiRobot-assisted surgical group and 73.3% (11/15) in the standard surgical group. The advantages with TiRobot on surgical time of screw placement, fluoroscopy frequency, and total drilling times were noted ( P =0.000). The nonunion rates were 5.6% (1/18) in the TiRobot-assisted surgical group and 33.3% (5/15) in the standard group ( P =0.039). Healing time in the union cases had a significant difference ( P =0.031). Functional outcome scores in the TiRobot-assisted surgical group were superior to that in the standard group ( P =0.014). Conclusions The findings showed that TiRobot-assisted sacroiliac screw fixation and bone grafting was a safe and effective surgical treatment option that had a reduced radiation dose and improved fracture healing, when compared with standard screw fixation without bone grafting.

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Section: Introductionmentioning

confidence: 99%

Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients

Liu

Jin

et al. 2021

Med Sci Monit

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“…The purpose of surgical fixation is reconstruction of the lumbopelvic area to avoid malunion and allow early weight-bearing. The transiliac plate 2,3 , sacroiliac screws 4,5 , and transiliac rods fixation 6,7 can be optimal options for posterior pelvic ring injuries. However, all of above are unable to stabilize the lumbopelvic junction.…”

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confidence: 99%

Robot‐Aided Minimally Invasive Lumbopelvic Fixation in Treatment of Traumatic Spinopelvic Dissociation

Liu

Tian

et al. 2021

Orthopaedic Surgery

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Objective: To investigate the surgical strategy, safety, and efficacy of close reduction and robot-aided minimally invasive lumbopelvic fixation in treatment of traumatic spinopelvic dissociation. Methods: Data of 32 patients (21 males and 11 females) with traumatic spinopelvic dissociation treated by lumbopelvic fixation with robot-aided minimally invasive technique or conventional open procedure in our institution from March 2010 to April 2019 were retrospectively analyzed, and divided into robot group and control group. Intraoperative blood loss, surgical time, fluoroscopy frequency, total drilling times, infection rate, hospitalization time, and sacral fracture healing time were reviewed. Radiographs and computed tomography (CT) scans were totally acquired to evaluate the reduction quality, residual fracture displacement, and Gras classification on screws insertion after surgery. According to the Majeed scoring system, functional outcome was assessed for each patient at the final follow-up. Results: There were 12 patients in the robot group and 20 patients in the control group with no significant difference about the demographic data. The average surgical time was 148.3 ± 40.5 min with intraoperative blood loss of 142.5±36.7 mL in the robot group and 185.0 ± 47.8 min with 612.5 ± 182.7 mL in the control group (P = 0.034, P = 0.000). The robot group had a shorter mean hospitalization time at 19.9 ± 7.0 days compared to the control group with 28.6 ± 5.4 days (P = 0.010). The fluoroscopy frequency was 35.4 ± 3.0 in the robot group and 45.5 ± 3.6 in the control group (P = 0.000) and total drilling times were 7.1 ± 1.1 and 9.6 ± 1.3 (P = 0.000), respectively. The infection rate was 0% (0/12) in the robot group and 15% (3/20) in the control group (P = 0.159). According to the Gras classification on screw positioning, there were 11 cases in Grade I and 1 case in Grade II in the robot group, and 14 cases in Grade I and 6 cases in Grade II in the control group. All the patients were followed up consecutively for at least 12 months, with an average follow-up period of 17.1 ± 3.6 months. All sacral fractures healed with an average time of 3.8 ± 0.6 months in the robot group and 4.7 ± 0.7 months in the control group (P = 0.000). According to Majeed functional assessment investigation, the mean score of the patients was 87.2 ± 4.0 in the robot group and 83.1 ± 4.5 in the control group (P = 0.015). Conclusions: Robot-aided minimally invasive lumbopelvic fixation for traumatic spinopelvic dissociation is a safe and feasible option with advantages of less intraoperative blood loss, less radiation damage, less hospitalization time, and better functional outcome.

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“…Iliosacral and transsacral-transiliac screw fixations are commonly used for the treatment of posterior pelvic injuries because they are minimally invasive. [12] In the iliosacral screw fixation, the iliac wing is the entry point and the sacral vertebra body is the target. In transacral-transiliac screw fixation, the entry point is the iliac wing, while the target point is the opposite iliac wing.…”

Section: Discussionmentioning

confidence: 99%

Do three-dimensional modeling and printing technologies have an impact on the surgical success of percutaneous transsacral screw fixation?

2020

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Caused by high-energy traumas, pelvic injuries are life-threatening complex injuries posing several unfavorable effects on the body. Pelvic fractures account for approximately 3-4.3% of all skeletal fractures. [1,2] Mortality rates due to pelvic injuries vary from 10 to 16%. [1,3] Victims of these injuries display an increased tendency to develop complications due to the nature of the injury and modes of treatment. [4-8] Complications are critical for patient survival and sequelae development. Percutaneous iliosacral and transsacral-transiliac screw fixation are the commonly preferred surgical methods for the treatment of posterior pelvic injuries. The advantages of this technique include minimal tissue damage due to the surgical procedure, improved stability of the fixation, short surgery time, and reduced risk for wound-related problems in the postoperative period. [9,10] However, patients may be prone to develop complications due to some factors, including variability in pelvic anatomy, the narrowness of the bone corridor to be screwed, and inadequacies in imaging and Objectives: This study aims to determine the role of computed tomography (CT)-derived templates, produced by threedimensional (3D) modeling, image processing and printing technology, in percutaneous transsacral screw fixation and evaluate the effects of their use on surgical success. Materials and methods: This prospective study conducted between June 2018 and December 2019 utilized 15 composite pelvis models for transsacral-transiliac screw fixation. For the procedure, modeled templates were utilized for wiring on the left side of the pelvis models, while the conventional method was performed on the right side of the pelvis models. In the computed tomography images acquired after wiring, appropriate wire position was evaluated. Results: The placed wires held the S1 body appropriately in all of the procedures with or without template use. With the template use, the wires were placed appropriately in the surgical bone corridor suitable for the transsacral-transiliac screw fixation in all of the models. However, with the conventional methods, the wires were not placed in the safe surgical bone corridor in four models. The wire deviation angle in the axial plane was significantly lower in the template group (p=0.001), whereas it was not different between the template group and the conventional method group in the coronal plane (p=0.054). The amount of deviation from the ideal wire entry site was significantly reduced in the template group compared to the conventional method group (p=0.001). Conclusion: With the use of 3D modeling and printing technology, CT-derived templates can be produced and utilized for transsacral screw fixation procedures and their use increases surgical success by reducing the surgical margin of error.

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Percutaneous Sacroiliac Screw Technique

Cited by 24 publications

References 0 publications

Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients

Comparison of Outcomes Following TiRobot-Assisted Sacroiliac Screw Fixation with Bone Grafting and Traditional Screw Fixation without Bone Grafting for Unstable Osteoporotic Sacral Fracture: A Single-Center Retrospective Study of 33 Patients

Robot‐Aided Minimally Invasive Lumbopelvic Fixation in Treatment of Traumatic Spinopelvic Dissociation

Do three-dimensional modeling and printing technologies have an impact on the surgical success of percutaneous transsacral screw fixation?

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