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Metastatic renal cell carcinoma of the lumbar spine with long posterior instrumented fusion and repetitive dislodgement of the set screws of the S2 alar-iliac screw – Lumbar Fusion

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This article reports on a case of repetitive dislodgement of set screws in S2 alar-iliac screws (S2AIS) following a posterior instrumented fusion. The patient, a 68-year-old male, underwent surgery for an L3 metastasis and L2-L3 subluxation. Despite the use of bilateral S2AIS fixation, the set screws repeatedly dislodged, leading to the need for two additional operations. The final surgery involved multiple anchors to the ilium, which successfully provided adequate fixation until the patient’s death. The study concludes that the set screw fixing force was weaker than the fixing force of the S2AIS and that multiple iliac anchors effectively salvaged this condition

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised treatment hospital in UK

Published article

: The set screw fixing force was weaker than the fixing force of the S2AIS; multiple iliac anchors effectively salvaged this condition.

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Surg Neurol Int. 2023 Dec 22;14:439. doi: 10.25259/SNI_859_2023. eCollection 2023.ABSTRACTBACKGROUND: S2 alar-iliac screws (S2AIS) are widely used to anchor the pelvis to a lumbar fusion. Here, we report a patient who experienced repetitive dislodgement of the set screws of the S2AIS following a posterior instrumented fusion.CASE DESCRIPTION: A 68-year-old male presented with an L3 metastasis,

Surg Neurol Int. 2023 Dec 22;14:439. doi: 10.25259/SNI_859_2023. eCollection 2023.

ABSTRACT

BACKGROUND: S2 alar-iliac screws (S2AIS) are widely used to anchor the pelvis to a lumbar fusion. Here, we report a patient who experienced repetitive dislodgement of the set screws of the S2AIS following a posterior instrumented fusion.

CASE DESCRIPTION: A 68-year-old male presented with an L3 metastasis and L2-L3 subluxation attributed to renal cell cancer. Following an L2-L5 posterior decompression and T9-pelvic fusion utilizing bilateral S2AIS fixation, the set screws of the S2AIS repeatedly dislodged, requiring two additional operations. The final surgery required multiple anchors to the ilium and provided adequate fixation until the patient’s expiration.

: The set screw fixing force was weaker than the fixing force of the S2AIS; multiple iliac anchors effectively salvaged this condition.

PMID:38213444 | PMC:PMC10783691 | DOI:10.25259/SNI_859_2023

The London Spine Unit : best recognised treatment hospital in UK

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Metastatic renal cell carcinoma of the lumbar spine with long posterior instrumented fusion and repetitive dislodgement of the set screws of the S2 alar-iliac screw

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Surg Neurol Int. 2023 Dec 22;14:439. doi: 10.25259/SNI_859_2023. eCollection 2023.ABSTRACTBACKGROUND: S2 alar-iliac screws (S2AIS) are widely used to anchor the pelvis to a lumbar fusion. Here, we report a patient who experienced repetitive dislodgement of the set screws of the S2AIS following a posterior instrumented fusion.CASE DESCRIPTION: A 68-year-old male presented with an L3 metastasis
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