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

摘要

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 S 1 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 L5-S 1.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.