Abstract
Pelvic instrumentation in spine surgery provides crucial fixation to the distal end of a long-construct fusion or added support to comminuted sacral fractures or pelvic ring injuries. Studies have shown increased rates of pseudoarthrosis when fixation is terminated at S1 in deformity cases. There are several techniques with which the pelvis can be instrumented. The most common is the iliac bolt, but S2-alar-iliac (S2AI) screw has gained popularity due to in-line connection to the cephalad construct and lower profile. Both can be placed safely via a percutaneous technique.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tsuchiya K, Bridwell KH, Kuklo TR, Lenke LG, Baldus C. Minimum 5-year analysis of L5–S1 fusion using sacropelvic fixation (bilateral S1 and iliac screws) for spinal deformity. Spine. 2006;31(3):303–8.
O’Brien JR, Yu WD, Bhatnagar R, Sponseller P, Kebaish KM. An anatomic study of the S2 iliac technique for lumbopelvic screw placement. Spine. 2009;34(12):E439–42.
Edwards CC 2nd, Bridwell KH, Patel A, Rinella AS, Berra A, Lenke LG. Long adult deformity fusions to L5 and the sacrum. A matched cohort analysis. Spine. 2004;29(18):1996–2005.
Edwards CC 2nd, Bridwell KH, Patel A, Rinella AS, Jung Kim Y, Berra AB, et al. Thoracolumbar deformity arthrodesis to L5 in adults: the fate of the L5-S1 disc. Spine. 2003;28(18):2122–31.
Kim YJ, Bridwell KH, Lenke LG, Cho KJ, Edwards CC 2nd, Rinella AS. Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am. 2006;88(4):721–8.
Cunningham BW, Lewis SJ, Long J, et al. Biomechanical evaluation of lumbosacral reconstruction techniques for spondylolisthesis: an in vitro porcine model. Spine. 2002;27:2321–7.
Lebwohl NH, Cunningham BW, Dmitriev A, et al. Biomechanical comparison of lumbosacral fixation techniques in a calf spine model. Spine. 2002;27:2312–20.
McCord DH, Cunningham BW, Shono Y, et al. Biomechanical analysis of lumbosacral fixation. Spine. 1992;17(suppl 8):S235–43.
O’Brien JR, Yu WD, Kaufman BE, Bucklen B, Salloum K, Khalil S, et al. Biomechanical evaluation of S2 alar-iliac screws: effect of length and quad-cortical purchase as compared to iliac fixation. Spine. 2013;38(20):E1250–5.
Nottmeier EW, Pirris SM, Balseiro S, Fenton D. Three-dimensional image-guided placement of S2 alar screws to adjunct or salvage lumbosacral fixation. Spine. 2010;10(7):595–601.
Schildhauer TA, McCulloch P, Chapman JR, Mann FA. Anatomic and radiographic considerations for placement of transiliac screws in lumbopelvic fixations. J Spinal Disord Tech. 2002;15(3):199–205; discussion 205.
O’Brien JR, Matteini L, Yu WD, Kebaish KM. Feasibility of minimally invasive sacropelvic fixation: percutaneous S2 alar iliac fixation. Spine. 2010;35(4):460–4.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Matteini, L. (2020). Percutaneous Iliac and S2AI Fixation. In: O'Brien, J., Kalantar, S., Drazin, D., Sandhu, F. (eds) The Resident's Guide to Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-20847-9_26
Download citation
DOI: https://doi.org/10.1007/978-3-030-20847-9_26
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-20846-2
Online ISBN: 978-3-030-20847-9
eBook Packages: MedicineMedicine (R0)