[S2-Ala-iliac screws for extended pelvic fixation in longer lumbar instrumentations : Description of a freehand technique].
Oper Orthop Traumatol. 2017 Aug;29(four):360-372
Authors: Lattig F, Weckbach S
OBJECTIVE: To scale back the speed of implant failures on the lumbosacral junction in polysegmental lumbar fusions.
INDICATIONS: Spinal fusion with deformity correction together with L5/S1, revision surgical procedure for pseudoarthrosis L5/S1, screw pull-out and pedicle fractures in S1, and S1/S2 fractures after polysegmental fusions.
CONTRAINDICATIONS: Osteosynthesis of complicated pelvic ring fractures, tumors of the ilium. Relative contraindication: an infection, to keep away from contamination of the iliosacral joint.
SURGICAL TECHNIQUE: Standard posterior strategy to the lumbar backbone. Positioning of the lumbar and S1 pedicle screws in frequent method. Identification of the right entrance level for one or two S2-Ala-iliac screws for all sides and preparation of the drill holes in freehand method. Connection of the lumbar and S1 pedicle screws and S2-Ala-iliac screws with one stress-free rod on all sides with out using connectors or particular plates.
POSTOPERATIVE MANAGEMENT: Again-friendly mobilization starting on day 1 after surgical procedure with help of a physiotherapist. No sports activities for 12 weeks.
RESULTS: In all, 25 sufferers had been handled with an prolonged pelvic fixation utilizing S2-Ala-iliac screws. A major deformity correction was carried out in 11 sufferers, whereas 14 sufferers underwent revision surgical procedure. A complete of 24 sufferers had been clinically and radiologically adopted for a imply of 16 months. Two sufferers confirmed a loosening of the S2-Ala-iliac screws on one facet, and one affected person had damaged screw as effectively solely on one facet with out medical signs. Up to now, no affected person has undergone revision surgical procedure due to S2-Ala-iliac screw-associated issues.
PMID: 28631069 [PubMed – indexed for MEDLINE]