Iatrogenic sacroiliac joint syndrome after percutaneous pedicle screw fixation at the L5-S1 level: case report

Neurosurgery
Yong Ahn, Sang-Ho Lee

Abstract

This article reports an unexpected complication of percutaneous pedicle screw fixation at the L5-S1 level. We describe a 66-year-old man who underwent anterior lumbar interbody fusion followed by percutaneous pedicle screw fixation at the L5-S1 level. The Sextant pedicle screw system was used. The patient experienced postoperative sacroiliac joint syndrome caused by the screw head and rod tip. In the immediate postoperative period, the preoperative right-side leg pain improved, but the patient complained of left-side buttock and leg pain. The left-side screws were removed, and after revision surgery, the left-side pain disappeared. However, at that time, right-side pain recurred. We found that the screw head and rod had violated the iliac crest and the sacroiliac joint, causing referred pain rather than radicular pain. After the screw head was repositioned and the rod was replaced with a new shorter rod with a blunt end, the patient's symptom was relieved. Surgeons should be aware of this unprecedented adverse effect when planning percutaneous pedicle screw fixation at the L5-S1 level. An android pelvis with a narrow and high iliac crest can be a risk factor. Careful preoperative evaluation and more accurate surgical technique ...Continue Reading

References

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Citations

May 15, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Hiroyuki Yoshihara
Nov 28, 2013·Journal of Korean Neurosurgical Society·Dong-Young ChoChun-Kun Park

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