Commentary: Quad S2-Alar-Iliac Screw Fixation via Navigated Spinal Robotics With Software Planning: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (5) ◽  
pp. E524-E525
Author(s):  
Arunit J S Chugh ◽  
Manish K Kasliwal
Keyword(s):  
Screw Fixation ◽  
Iliac Screw

A biomechanical investigation of the sacroiliac joint in the setting of lumbosacral fusion: impact of pelvic fixation versus sacroiliac joint fixation

2019 ◽  
Vol 31 (4) ◽  
pp. 562-567 ◽  
Author(s):  
Harry Mushlin ◽  
Daina M. Brooks ◽  
Joshua Olexa ◽  
Bryan J. Ferrick ◽  
Stephen Carbine ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Screw Fixation ◽  
Intact Specimen ◽  
Lumbosacral Fusion ◽  
Pelvic Fixation ◽  
Biomechanical Investigation ◽  
Flexion Extension ◽  
Iliac Screw ◽  
Sacroiliac Fusion ◽  
Bending Modes

OBJECTIVEThe sacroiliac joint (SIJ) is a known source of low-back pain. Randomized clinical trials support sacroiliac fusion over conservative management for SIJ dysfunction. Clinical studies suggest that SIJ degeneration occurs in the setting of lumbosacral fusions. However, there are few biomechanical studies to provide a good understanding of the effect of lumbosacral fusion on the SIJ. In the present study, researchers performed a biomechanical investigation to discern the effect of pelvic versus SIJ fixation on the SIJ in lumbosacral fusion.METHODSSeven fresh-frozen human cadaveric specimens were used. There was one intact specimen and six operative constructs: 1) posterior pedicle screws and rods from T10 to S1 (PS); 2) PS + bilateral iliac screw fixation (BIS); 3) PS + unilateral iliac screw fixation (UIS); 4) PS + UIS + 3 contralateral unilateral SIJ screws (UIS + 3SIJ); 5) PS + 3 unilateral SIJ screws (3SIJ); and 6) PS + 6 bilateral SIJ screws (6SIJ). A custom-built 6 degrees-of-freedom apparatus was used to simulate three bending modes: flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Range of motion (ROM) was recorded at L5–S1 and the SIJ.RESULTSAll six operative constructs had significantly reduced ROM at L5–S1 in all three bending modes compared to that of the intact specimen (p < 0.05). In the FE mode, the BIS construct had a significant reduction in L5–S1 ROM as compared to the other five constructs (p < 0.05). SIJ ROM was greatest in the FE mode compared to LB and AR. Although the FE mode did not show any statistically significant differences in SIJ ROM across the constructs, there were appreciable differences. The PS construct had the highest SIJ ROM. The BIS construct reduced bilateral SIJ ROM by 44% in comparison to the PS construct. The BIS and 6SIJ constructs showed reductions in SIJ ROM nearly equal to those of the PS construct. UIS and 3SIJ showed an appreciable reduction in unfused SIJ ROM compared to PS.CONCLUSIONSThis investigation demonstrated the effects of various fusion constructs using pelvic and sacroiliac fixation in lumbosacral fusion. This study adds biomechanical evidence of adjacent segment stress in the SIJ in fusion constructs extending to S1. Unilateral pelvic fixation, or SIJ fusion, led to an appreciable but nonsignificant reduction in the ROM of the unfused contralateral SIJ. Bilateral pelvic fixation showed the greatest significant reduction of movement at L5–S1 and was equivalent to bilateral sacroiliac fusion in reducing SIJ motion.

scholarly journals The technique of S2-alar-iliac screw fixation: a literature review

2017 ◽  
Vol 2 ◽  
pp. 179-179 ◽  
Author(s):  
Ai-Min Wu ◽  
◽  
Dong Chen ◽  
Chun-Hui Chen ◽  
Yu-Zhe Li ◽  
...  
Keyword(s):  
Literature Review ◽  
Screw Fixation ◽  
Iliac Screw

Palliative dual iliac screw fixation for lumbosacral metastasis

2007 ◽  
Vol 7 (1) ◽  
pp. 99-102 ◽  
Author(s):  
Shunsuke Fujibayashi ◽  
Masashi Neo ◽  
Takashi Nakamura
Keyword(s):  
Screw Fixation ◽  
Spinal Metastases ◽  
Clinical Results ◽  
Spinal Fixation ◽  
Spinal Disease ◽  
Metastatic Lesions ◽  
Iliac Screw ◽  
Rod Breakage ◽  
Early Wound

✓ Spinal fixation for destructive metastatic lesions at the lumbosacral junction is challenging because of the large and unique load-bearing characteristics present. In particular, caudal fixation is difficult in cases of sacral destruction because of insufficient S-1 pedicle screw anchorage. The authors describe their surgical technique for secure iliac screw placement and the clinical results obtained in five patients with metastatic spinal disease. All patients in this study underwent palliative operations with dual iliac screw fixation between April 1999 and October 2002, and the clinical and radiological findings were assessed. In all five patients, spinal metastases extended into the sacrum. The metastases were from renal cell carcinomas in two patients, lung cancer in two, and a paraganglioma in one patient. Postoperative follow-up periods ranged from 3 months to 6 years (mean 28.4 months). Preoperatively, four patients could not walk due to severe pain or neurological compromise. Postoperatively, all patients reported a reduction in pain and regained the ability to walk. Complications included one case of early wound infection. In the patients with long survival after the operation, there was one case of iliac screw loosening and one case of rod breakage. The dual iliac screw fixation technique provided sufficient immediate stability for destructive lumbosacral metastasis.

scholarly journals S-1 and S-2-alar-iliac screw fixation via intraoperative navigation

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1
Author(s):  
Martin H. Pham ◽  
Andre M. Jakoi ◽  
Patrick C. Hsieh
Keyword(s):  
Spinal Deformity ◽  
Screw Fixation ◽  
Adult Spinal Deformity ◽  
Intraoperative Navigation ◽  
Case Presentation ◽  
Adult Deformity ◽  
Sacropelvic Fixation ◽  
Fixation Techniques ◽  
Iliac Screw ◽  
Bicortical Screw

Adult deformity patients often require fixation to the sacrum and pelvis for construct stability and improved fusion rates. Although certain sacropelvic fixation techniques can be challenging, the availability of intraoperative navigation has made many of these techniques more feasible. In this video case presentation, the authors demonstrate the techniques of S-1 bicortical screw and S-2-alar-iliac screw fixation under intraoperative navigation in a 67-year-old female. This instrumentation placement was part of an overall T-10–pelvis construct for the correction of adult spinal deformity.The video can be found here: https://youtu.be/3HZo-80jQr8.

scholarly journals Technique and nuances of an S-2 alar iliac screw for lumbosacral fixation in patients with transitional and normal anatomy

2016 ◽  
Vol 41 (videosuppl1) ◽  
pp. 1 ◽  
Author(s):  
Junichi Ohya ◽  
Todd D. Vogel ◽  
Sanjay S. Dhall ◽  
Sigurd Berven ◽  
Praveen V. Mummaneni
Keyword(s):  
Screw Fixation ◽  
Insufficiency Fracture ◽  
The Other ◽  
Rigid Fixation ◽  
Normal Anatomy ◽  
Sacral Insufficiency Fracture ◽  
Pelvic Fixation ◽  
Low Profile ◽  
Iliac Screw ◽  
Lumbosacral Fixation

S-2 alar iliac (S2AI) screw fixation has recently been recognized as a useful technique for pelvic fixation. The authors demonstrate two cases where S2AI fixation was indicated: one case was a sacral insufficiency fracture following a long-segment fusion in a patient with a transitional S-1 vertebra; the other case involved pseudarthrosis following lumbosacral fixation. S2AI screws offer rigid fixation, low profile, and allow easy connection to the lumbosacral rod. The authors describe and demonstrate the surgical technique and nuances for the S2AI screw in a case with transitional S-1 anatomy and in a case with normal S-1 anatomy.The video can be found here: https://youtu.be/Sj21lk13_aw.

Long-Term Outcomes and Complications of Unilateral vs Bilateral Iliac Screw Fixation in Adult Deformity Surgery

2017 ◽  
Vol 17 (10) ◽  
pp. S169
Author(s):  
Michael S. Chang ◽  
Dennis G. Crandall ◽  
Jan Revella ◽  
Yu-Hui Chang
Keyword(s):  
Screw Fixation ◽  
Long Term Outcomes ◽  
Adult Deformity ◽  
Iliac Screw
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