Percutaneous and open iliac screw security and accuracy utilizing a tactile method with adjunctive anteroposterior fluoroscopy.
Backbone J. 2018 Feb 21;:
Authors: George SG, Lebwohl NH, Pasquotti G, Williams SK
BACKGROUND CONTEXT: All at present described percutaneous iliac screw placement strategies are completely depending on fluoroscopy.
PURPOSE: The aim of this research was to find out the security and accuracy of percutaneous and open iliac screw placement utilizing a primarily tactile method with adjunctive AP fluoroscopy.
STUDY DESIGN/CONTEXT: All sufferers who underwent open and percutaneous iliac screw placement over a 5-year interval had been recognized. Charts had been reviewed to evaluate for any situations of neurological or vascular harm related to iliac screw placement. Screw accuracy was judged with post-operative CT scans.
PATIENT SAMPLE: 133 sufferers had been recognized who underwent open or percutaneous iliac screw placement. CT scans had been accessible for 57 sufferers, and all of those sufferers had been included within the research, with a complete of 115 iliac screws.
OUTCOME MEASURES: Radiographic measurements had been carried out, consisting of the gap of the iliac screw to the sciatic notch on post-operative radiographs and CT scans. CT scans had been used to find out iliac screw accuracy.
METHODS: Charts had been reviewed to evaluate for any neurological or vascular accidents associated to screw placement. The space of the iliac screw to the sciatic notch was measured and in contrast on AP radiographs and CT scans. CT scans had been assessed for any screw violation of the iliac cortex or sciatic notch. The accuracy of open iliac screw placement was in comparison with minimally-invasive percutaneous placement. The research was not funded. There are not any conflicts of curiosity to report which are pertinent to this research.
RESULTS: There have been no neurological or vascular accidents associated to screw placement in 133 sufferers. CT scans had been accessible for 115 iliac screws, with three cortical breaches, all by lower than 2 mm. All 112 different screws had been precisely intraosseous. There was a robust correlation between the iliac screw to sciatic notch distance when measured by CT scan in comparison with AP radiographs (r=zero.9), thus validating the accuracy of AP fluoroscopy in guiding iliac screw placement with respect to the sciatic notch. Iliac screw accuracy was equal with the open and percutaneous insertion methods.
CONCLUSIONS: The described surgical method represents a secure and dependable surgical choice for iliac screw placement. Intraoperative AP fluoroscopy precisely displays the gap of the iliac screw to the sciatic notch. Percutaneous iliac screws positioned with this method are as correct as open iliac screws.
PMID: 29476809 [PubMed – as supplied by publisher]