The indications for surgery included frequent recurrent low-back and/or leg pain, neurological deficits, severe disability and/or progressive deformity that failed to better with conservative treatment for more than 6 months. Therefore, the aim of this study was to compare the radiographic change of sagittal spinopelvic parameters between these two techniques for the treatment of ASD, and assess the complication rate of our substantial case series.Īfter institutional review board approval, we performed a retrospective review of consecutive patients who underwent long-segment (≥6 levels) spinal fusion and pelvic fixation using IS or S2AI technique at a single institution between 20. To date, few studies exist specifically focused on the radiographic change of spinopelvic parameters after SPF utilizing IS and S2AI techniques. However, there are limited data regarding comparative data between these techniques. Additional, current literature reported the S2AI had several potential advantages over IS with lower rates of reoperation, wound dehiscence, and implant failure. This technique prevented hardware prominence owing to its deeper and more medial entry point compared to IS. In response to above drawbacks, the S2AI has recently become an increasingly popular technique as an alternative method of SPF, which was initially described by Dr. reported that up to 34% ASD patients treated via IS technique necessitating reoperations due to prominence. However, there are some disadvantages regarding the IS, including the need for lateral connector, more extensive tissue dissection, prominent hardware, and wound dehiscence etc. The IS had a long-established history of improving stability, with comparative advantages of greater diameter and length bolts could be used, higher pullout strength, and easier application. Currently, iliac screw (IS) and S2-alar-iliac (S2AI) screw fixations are the most popular method of SPF in clinical practice. With the emergence of advanced spinal instrumentation, multiple options have been described for additional SPF over the past decades. However, achieving solid fixation in lumbosacral junction continues to be a challenge for spine surgeons because of the tremendous biomechanical forces demand across the junctional area, complex regional anatomy, and a high pseudarthrosis rate, especially in patients with adult spinal deformity (ASD). This instrumentation technique can also be applied in high-grade spondylolisthesis, trauma, tumors or infection. Spinopelvic fixation (SPF) is becoming an increasingly important avenue for degenerative conditions as the aging population grows. Further study is warranted to clarify the clinical impaction of these results. ConclusionsĬompared with the S2AI technique, the IS technique usable larger cantilever force demonstrated more correction of lumbar lordosis, and possible increase in pelvic incidence. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%, p < 0.05) and (16.1% vs 3.6%, p < 0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° ( p < 0.05). ResultsĪ total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change < 5°. Demographics, intraoperative and clinical data were analyzed between the two groups. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Patients were divided into two groups based on whether IS or S2AI fixation was performed. MethodsĪ retrospective review of consecutive patients who underwent deformity correction surgery for ASD between 20 was performed. To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |