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Sacroiliac screw

Wenhao Song, Dongsheng Zhou, Yu He
BACKGROUND: The aim of this study was to compare the biomechanical characteristics between bilateral and unilateral lumbo-iliac fixation in unilateral comminuted sacral fractures (USF) by finite element analysis. METHODS: A 3-dimensional finite element model of unilateral sacral fractures was simulated. Three kinds of implants were instrumented into the model, including the unilateral lumbopelvic fixation (ULF), bilateral lumbopelvic fixation (BLF), and unilateral iliac fixation with bilateral lumbar pedicle screws (UBF)...
October 2016: Medicine (Baltimore)
Sei Yano, Yasuchika Aoki, Atsuya Watanabe, Takayuki Nakajima, Makoto Takazawa, Hiroyuki Hirasawa, Kazuhisa Takahashi, Koichi Nakagawa, Arata Nakajima, Hiroshi Takahashi, Sumihisa Orita, Yawara Eguchi, Takane Suzuki, Seiji Ohtori
Pelvic ring fractures are defined as life-threatening injuries that can be treated surgically with external or internal fixation. The authors report on an 81-year-old woman with an unstable pelvic fracture accompanying multiple traumas that was successfully treated with a less invasive procedure. The patient was injured in a traffic accident and sustained a total of 20 fractures, including pelvic ring, bilateral rib, and lumbar transverse processes fractures, and multiple fractures of both upper and lower extremities...
October 7, 2016: Journal of Neurosurgery. Spine
Ángel Lázaro Gonzálvez, Javier Martínez Reina, Pedro Cano Luis, Juan Jiménez Baquero, José Sueiro Fernández, Miguel Ángel Giráldez Sánchez
OBJECTIVES: The current biomechanical work compares the symphyseal and sacroiliac stability obtained with two systems of bone osteosynthesis. The two methods of fixation compared were the 6-hole suprapubic non-locked plate and pubic fixation with two cannulated screws, a novel technique that can be applied percutaneously in the clinical practice. The aim of this study was to examine the validity of the use of two-cannulated-screws osteosynthesis in order to minimize the secondary effects of open fixation, especially in patients in whom an open reduction is contraindicated...
September 2016: Injury
T Finger, S Bayerl, M Bertog, M Czabanka, J Woitzik, P Vajkoczy
OBJECTIVE: We hypothesised, that the inclusion of the ilium for multilevel lumbosacral fusions reduces the incidence of postoperative sacroiliac joint (SIJ) pain. The primary objective of this study was to compare the frequency of postoperative SIJ pain in patients undergoing multilevel stabilization with and without sacropelvic fixation for multilevel degenerative spine disease. In addition, we aimed at identifying factors that may predict the worsening or new onset of postoperative SIJ pain...
November 2016: Clinical Neurology and Neurosurgery
Niklas Grüneweller, Michael J Raschke, Ivan Zderic, Daniel Widmer, Dirk Wähnert, Boyko Gueorguiev, R Geoff Richards, Thomas Fuchs, Markus Windolf
Operative treatment of sacral insufficiency fractures is frequently being complicated by osteopenic bone properties. Cement augmentation of implanted sacroiliac screws may lead to superior construct stability and prevent mechanical complications. A novel hemi-pelvis test model with dissected symphysis was developed. Five fresh-frozen cadaveric pelvises were vertically osteotomized at the sacrum on both sides and fixed with sacroiliac screws in both corridors of the first sacral vertebral body. One side was randomly augmented with bone cement...
August 26, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Amir Herman, Emily Keener, Candice Dubose, Jason A Lowe
Percutaneous sacral screw fixation is the mainstay of posterior pelvic ring fixation. This study quantifies the accuracy of fluoroscopic screw placement using post-operative CT scans and redefines the fluoroscopic safe zone using a mathematical calculation obtained from Inlet and outlet images. The authors hypothesized that a mathematical calculation of screw placement within the ala will improve accuracy of screw placement. A retrospective review of consecutive patients admitted to a level 1 trauma center with pelvic fractures fixed with iliosacral screws from January 2011 to December 2014 was performed...
August 23, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
B Hari Krishnan, Yogesh Sharma, Girish Magdum
BACKGROUND: Unstable posterior pelvic and sacroiliac joint injuries are challenging fractures mostly managed conservatively in our military hospitals till date. We carried out a retrospective analysis of early fixation of these fractures at our hospital and compared it with the existing literature as regards its safety and efficacy. METHODS: A retrospective analysis of all patients admitted and managed by internal fixation for unstable posterior pelvic fractures was carried out for evaluation of its efficacy and safety...
July 2016: Medical Journal, Armed Forces India
Savyasachi C Thakkar, Rashmi S Thakkar, Norachart Sirisreetreerux, John A Carrino, Babar Shafiq, Erik A Hasenboehler
PURPOSE: Percutaneous sacroiliac (SI) fixation of unstable posterior pelvic ring injuries is a widely accepted procedure. The complex sacral anatomy with narrow osseous corridors for SI screw placement makes this procedure technically challenging. Techniques are constantly evolving as a result of better understanding of the posterior pelvic anatomy. Recently developed tools include fluoroscopy-based computer-assisted navigation, which can be two-dimensional (2D) or three-dimensional (3D)...
August 8, 2016: International Journal of Computer Assisted Radiology and Surgery
Michael Goetzen, Kevin Ortner, Richard A Lindtner, Rene Schmid, Michael Blauth, Dietmar Krappinger
BACKGROUND: Percutaneous sacroiliac screw fixation under fluoroscopic control is an effective method for posterior pelvic ring stabilization. However, sacral dysmorphism has a high risk of L5 nerve injury. This study describes a simple method for the preoperative assessment of the sacral morphology using CT scans with widely available tools. MATERIALS AND METHODS: CT scans of 1000 patients were analyzed. True inlet, outlet, and lateral views of the sacrum were obtained using a two-dimensional reconstruction tool to align the sacrum in a reproducible manner...
September 2016: Archives of Orthopaedic and Trauma Surgery
John Tidwell, Rosa Cho, J Spence Reid, Henry Boateng, Carol Copeland, Edward Sirlin
Remembering that preoperative planning, surgical indications, and fracture reduction are paramount for this procedure, presented here is our technique for performing percutaneous sacroiliac screws, both transiliac-transsacral and sacral style. A combination of video, still pictures, and fluoroscopy images will guide the viewer through the process we routinely use highlighting specific details. Patient positioning and intraoperative fluoroscopy imaging are critical to a successful procedure. Although inlet and outlet films remain important, we find the procedure best started on the lateral sacral view to reduce the need for start site, trajectory, and imaging position changes during the case...
August 2016: Journal of Orthopaedic Trauma
Claire Bruna-Rosso, Pierre-Jean Arnoux, Rohan-Jean Bianco, Yves Godio-Raboutet, Léo Fradet, Carl-Éric Aubin
BACKGROUND: Sacroiliac joint (SIJ) is a known chronic pain-generator. The last resort of treatment is the arthrodesis. Different implants allow fixation of the joint, but to date there is no tool to analyze their influence on the SIJ biomechanics under physiological loads. The objective was to develop a computational model to biomechanically analyze different parameters of the stable SIJ fixation instrumentation. METHODS: A comprehensive finite element model (FEM) of the pelvis was built with detailed SIJ representation...
2016: International Journal of Spine Surgery
Patrick C Hsieh, Praveen V Mummaneni
We are pleased to present this Neurosurgical Focus video supplement on lumbosacral and sacropelvic fixation strategies. Despite advancement in surgical techniques and technologies in spine, achieving consistent solid fusion across the lumbosacral junction remains a major challenge. The anatomy of the lumbosacral junction allows for a higher range of motion compared to other areas of the thoracolumbar spine. The L5-S1 interspace is exposed to significant shear forces. As a result, complications such as pseudoarthrosis, screw pull-out, implant fracture, or sacral fractures can occur...
July 2016: Neurosurgical Focus
Tomohiro Banno, Tsuyoshi Ohishi, Tomohiko Hasegawa, Yu Yamato, Sho Kobayashi, Daisuke Togawa, Tatsuya Yasuda, Yukihiro Matsuyama
STUDY DESIGN: Retrospective study. OBJECTIVE: To investigate the accuracy of freehand iliac screw insertion and to determine how this can be done safely. BACKGROUND AND METHODS: Seventy-seven adult scoliosis patients with an average age of 70.1 years who underwent spinal deformity surgery with spinopelvic fixation using bilateral iliac screws were enrolled. Penetration of the iliac table was assessed using postoperative computed tomography (CT)...
June 28, 2016: Clinical Spine Surgery
Peter M Formby, Scott C Wagner, Daniel G Kang, Gregory S Van Blarcum, Ronald A Lehman
BACKGROUND CONTEXT: As war injury patterns have changed throughout Operations Iraqi and Enduring Freedom (OIF and OEF), a relative increase in the incidence of complex lumbosacral dissociation (LSD) injuries has been noted. Lumbosacral dissociation injuries are an anatomical separation of the spinal column from the pelvis, and represent a manifestation of severe, high-energy trauma. PURPOSE: This study aimed to assess the clinical outcomes of combat-related LSD injuries at a mean of 7 years following operative treatment...
June 22, 2016: Spine Journal: Official Journal of the North American Spine Society
Marcus D Mazur, Mark A Mahan, Lubdha M Shah, Andrew T Dailey
BACKGROUND: S2-alar-iliac (S2AI) screws are 1 technique for lumbopelvic fixation to improve fusion rates across the lumbosacral junction that has gained wider acceptance. The S2AI screw crosses the cortical surfaces of the sacroiliac joint (SIJ), which may improve the biomechanical strength of the instrumentation. OBJECTIVE: To report preliminary radiographic outcomes of patients who underwent lumbopelvic fixation with S2AI screws with a minimum 12-month follow-up...
June 23, 2016: Neurosurgery
Georg Osterhoff, Andrew E Dodd, Florence Unno, Angus Wong, Shahram Amiri, Kelly A Lefaivre, Pierre Guy
BACKGROUND: Sacroiliac screw fixation in elderly patients with pelvic fractures is prone to failure owing to impaired bone quality. Cement augmentation has been proposed as a possible solution, because in other anatomic areas this has been shown to reduce screw loosening. However, to our knowledge, this has not been evaluated for sacroiliac screws. QUESTIONS/PURPOSES: We investigated the potential biomechanical benefit of cement augmentation of sacroiliac screw fixation in a cadaver model of osteoporotic bone, specifically with respect to screw loosening, construct survival, and fracture-site motion...
June 22, 2016: Clinical Orthopaedics and related Research
Benjamin D Elder, Wataru Ishida, Sheng-Fu L Lo, Christina Holmes, C Rory Goodwin, Thomas A Kosztowski, Ali Bydon, Ziya L Gokaslan, Jean-Paul Wolinsky, Daniel M Sciubba, Timothy F Witham
STUDY DESIGN: Retrospective comparative study. OBJECTIVE: To compare clinical and radiographic outcomes between the S2-alar-iliac (S2AI) and the iliac screw (IS) techniques in the adult population and clarify the clinical strength of S2AI screws. SUMMARY OF BACKGROUND DATA: S2AI screws have been described as an alternative method for lumbosacropelvic fixation in place of ISs. The S2AI technique has several advantages with lower prominence, increased ability to directly connect to proximal instrumentation, less extensive dissection of tissue, and enhanced biomechanical strength over the IS technique...
May 31, 2016: Spine
Colin G Murphy, James R Gill, Andrew D Carrothers, Peter D Hull
Fractures through the sacroiliac joint are very challenging to treat, technically difficult to reduce through closed methods on account of the multiaxial displacement of fractures fragments, frequently occur in very unwell patients, and have poor outcomes if malreduction is present. We describe a technique utilising the lateral window and a short buttress plate to reduce and stabilize the fragments prior to percutaneous fixation with sacroiliac screws.
April 2016: Archives of Bone and Joint Surgery
Loïc M Déjardin, Danielle M Marturello, Laurent P Guiot, Reunan P Guillou, Charles E DeCamp
OBJECTIVE: To compare accuracy and consistency of sacral screw placement in canine pelves treated for sacroiliac luxation with open reduction and internal fixation (ORIF) or minimally invasive osteosynthesis (MIO) techniques. METHODS: Unilateral sacroiliac luxations created experimentally in canine cadavers were stabilized with an iliosacral lag screw applied via ORIF or MIO techniques (n = 10/group). Dorsoventral and craniocaudal screw angles were measured using computed tomography multiplanar reconstructions in transverse and dorsal planes, respectively...
July 19, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Seong-Dae Yoon, Sung-Hyuk Yoon
INTRODUCTION: Iliosacral screw fixation has been commonly used for stabilization of the posterior ring in unstable pelvic fractures. However, loosening of the screw may develop with or without redisplacement of the fracture. This study was undertaken to evaluate the incidence of iliosacral screw loosening and to identify its predictive factors. MATERIALS AND METHODS: In total, 110 patients whose posterior pelvic ring was stabilized with iliosacral screws were enrolled...
July 2016: Archives of Orthopaedic and Trauma Surgery
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