Prevalence and Risk Factors of Iliac Screw Loosening After Adult Spinal Deformity Surgery

Banno, Tomohiro; Hasegawa, Tomohiko; Yamato, Yu; Kobayashi, Sho; Togawa, Daisuke; Oe, Shin; Mihara, Yuki; Matsuyama, Yukihiro

doi:10.1097/brs.0000000000002047

Cited by 50 publications

(57 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Old age, low screw density, large PI, history of revision surgery, failure to restore LL, postoperative sagittal imbalance, insufficient sacropelvic fixation, and other such factors have been reported as risk factors after sacropelvic fixation of screw loosening and pseudoarthrosis [3,[9][10][11]. Kim et al [9] reported that the rate of S1 screw loosening was 24.4% in 156 patients who underwent lumbosacral fixation for degenerative lumbar disease, and that the risk factors for screw loosening were age, poor BMD, long fusion (≥3 levels), high PI, and high mismatch of PI and LL.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have investigated the prevalence and risk factors for SAI screw loosening; therefore, limited information is available on this subject. The risk factors for distal junctional failure after long instrument fusion using iliac screws include advanced age, low screw density, large pelvic incidence (PI), revision surgery, failure to restore lumbar lordosis (LL), postoperative sagittal imbalance, and insufficient sacropelvic fixation [3,[9][10][11]. However, it is unclear whether these risk factors are associated with SAI screw loosening.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up

et al. 2020

View full text Add to dashboard Cite

Study Design: A retrospective cohort study.Purpose: The purpose of this study was to investigate the prevalence and risk factors for S2 alar-iliac (SAI) screw loosening following lumbosacral fixation, with a minimum 2-year follow-up.Overview of Literature: Although SAI screws allow surgeons to perform lumbosacral fixation with a low profile and enhanced biomechanical strength, screw loosening following surgery can occur in some cases. However, few studies have investigated the prevalence and risk factors for SAI screw loosening.Methods: This retrospective study included 35 patients (mean age, 72.8±8.0 years; male, 10; female, 25) who underwent lumbosacral fixation using SAI screws with at least 2 years of follow-up. SAI screw loosening and L5–S bony fusion were assessed using computed tomography. The period for which the screws appeared loose and the risk factors for SAI screw loosening were investigated 2 years after surgery.Results: A total of 70 SAI screws and 70 S1 pedicle screws were inserted. Loosening was observed 0.5, 1, and 2 years after surgery in 17 (24.3%), 35 (50.0%), and 35 (50.0%) SAI screws, respectively. Bony fusion rate at L5–S was significantly lower in patients with SAI screw loosening than in those without screw loosening (65.0% vs. 93.3%, p =0.048). The score for SAI screw contact with the iliac cortical bone and the bony fusion rate at L5–S were significantly lower in the loosening group than in the non-loosening group (1.8±0.5 vs. 2.2±0.3, p <0.001, respectively). Postoperative pelvic incidence–lumbar lordosis was significantly higher in the loosening group than in the non-loosening group (7.9°±15.4° vs. 0.5°±8.7°, p =0.02, respectively).Conclusions: SAI screw loosening is closely correlated with pseudoarthrosis at L5–S. Appropriate screw insertion and optimal lumbar lordosis restoration are important to prevent postoperative complications related to SAI screws.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In our results, no loosening occurred in the nine repositioned screws. Banno et al 1) reported that the loosening group had a significantly higher rate of misplacement than the non-loosening group (54.5% vs. 16.0%). However, in our results, only one lateral wall violation occurred in 15 loosened screws, and no loosening occurred in the other misplaced screws.…”

Section: Discussionmentioning

confidence: 99%

“…The surgeons should keep in mind that inferior wall or lateral wall perforation of iliac screw leads to postoperative pain that could require revision surgery. Screw loosening, represented as a radiolucent area around the screw, indicates loss of screw fixation and potential progression to pseudarthrosis 1,17) . The prevalence of iliac screw loosening after long spinal fusion is known to be particularly high (7.5-52%) 3,11,22) .…”

Section: Discussionmentioning

confidence: 99%

Accuracy Analysis of Iliac Screw Using Freehand Technique in Spinal Surgery : Relation between Screw Breach and Revision Surgery

Lee

Jung

Keshen

et al. 2020

J Korean Neurosurg Soc

View full text Add to dashboard Cite

Objective :To analyze the accuracy of iliac screws using freehand technique performed by the same surgeon. We also analyzed how the breach of iliac screws was related to the clinical symptoms resulting in revision surgery. Methods : From January 2009 to November 2015, 100 patients (193 iliac screws) were analyzed using postoperative computed tomography scans. The breaches were classified based on the superior, inferior, lateral, and medial iliac wall violation by the screw. According to the length of screw extrusion, the classification grades were as follows : grade 1, screw extrusion <1 cm; grade II, 1 cm ≤ screw extrusion <2 cm; grade III, 2 cm ≤ screw extrusion <3 cm; and grade IV, 3 cm ≤ screw extrusion. We also reviewed the revision surgery associated with iliac screw misplacement. Results : Of the 193 inserted screws, 169 were correctly located and 24 were misplaced screws. There were eight grade I, six grade II, six grade III, and four grade IV screw breaches, and 11, 8, 2, and 3 screws violated the medial, lateral, superior, and inferior walls, respectively. Four revision surgeries were performed for the grade III or IV iliac screw breaches in the lateral or inferior direction with respect to its related symptoms. Conclusion : In iliac screw placement, 12.4% breaches developed. Although most breaches were not problematic, symptomatic violations (2.1%) could result in revision surgery. Notably, the surgeon should keep in mind that lateral or inferior wall breaches longer than 2 cm can be risky and should be avoided.

show abstract

“…Тактика лечения рассматриваемой патологии не имеет общего шаблона, поскольку зависит не только от особенностей заболевания позвоночника, но и от ряда индивидуальных факторов, присутствующих у конкретного пациента. В случае выбора хирургического метода лечения, некоторыми авторами предлагается вовсе избегать инструментальной фиксации при лечении пациентов с сопутствующим остеопорозом [9,10,11]. Однако критиче-ские формы дегенеративного сколиоза с выраженной полисегментарной симптоматикой являются показанием для реконструктивных хирургических вмешательств с необходимостью имплантации металлоконструкции, стабилизирующей позвоночник.…”

Section: вопросы вертебрологииunclassified

Analysis of the causes of proximal junctional kyphosis following spinal instrumented fixation in patients with bone mineral density deficiency

Басанкин¹,

Порханов²,

Пташников³

et al. 2019

View full text Add to dashboard Cite

здравоохранения «Научно-исследовательский институт-Краевая клиническая больница № 1 имени профессора С.В. Очаповского» Министерства здравоохранения Краснодарского края, г. Краснодар, Россия 2 Федеральное государственное бюджетное учреждение «Российский ордена Трудового Красного Знамени научно-исследовательский институт травматологии и ортопедии имени Р.Р. Вредена» Министерства здравоохранения Российской Федерации, г. Санкт-Петербург, Россия 3 Федеральное государственное бюджетное образовательное учреждение высшего образования «Кубанский государственный медицинский университет» Министерства здравоохранения Российской Федерации, г. Краснодар, Россия Analysis of the causes of proximal junctional kyphosis following spinal instrumented fixation in patients with bone mineral density deficiency

show abstract

Prevalence and Risk Factors of Iliac Screw Loosening After Adult Spinal Deformity Surgery

Abstract: 4.

Cited by 50 publications

References 31 publications

The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up

The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up

Accuracy Analysis of Iliac Screw Using Freehand Technique in Spinal Surgery : Relation between Screw Breach and Revision Surgery

Analysis of the causes of proximal junctional kyphosis following spinal instrumented fixation in patients with bone mineral density deficiency

Contact Info

Product

Resources

About