Title: A novel technique for sacropelvic fixation using image-guided sacroiliac screws: a case series and biomechanical study


Authors: Kee D. Kim1, Huy Duong2, Aditya Muzumdar3, Mir Hussain3, Mark Moldavsky3, Bandon Bucklen3


Institutions: 1Department of Neurological Surgery, University of California, Davis, Sacramneto, CA 95817, USA; 2Department of Neurosurgery, Kaiser Permanente Medical Group, Sacramento, CA 95825, USA; 3Musculoskeletal Education and Research Center (MERC), Globus Medical Inc, Audubon, PA 19403, USA.


Abstract: In this study, we sought to assess the safety and accuracy of sacropelvic fixation performed with image-guided sacroiliac screw placement using postoperative computed tomography and X-rays. The sacroiliac screws were placed with navigation in five patients. Intact specimens were mounted onto a six-degrees-of-freedom spine motion simulator. Long lumbosacral constructs using bilateral sacroiliac screws and bilateral S1 pedicle and iliac screws were tested in seven cadaveric spines. Nine sacroiliac screws were well-placed under an image guidance system (IGS); one was placed poorly without IGS with no symptoms. Both fixation techniques significantly reduced range of motion (P < 0.05) at L5S1. The research concluded that rigid lumbosacral fixation can be achieved with sacroiliac screws, and image guidance improves its safety and accuracy. This new technique of image-guided sacroiliac screw insertion should prove useful in many types of fusion to the sacrum, particularly for patients with poor bone quality, complicated anatomy, infection, previous failed fusion and iliac harvesting.


Keywords: lumbosacral fixation, sacropelvic fixation, sacroiliac screw, computer-assisted surgery, image-guided surgery


Full Text: JBR-2017-0077.pdf


J Biomed Res published on 15 June 2018, https://doi.org/10.7555/JBR.32.20170077