Minimally invasive sacroiliac fixation in oncologic patients with sacral insufficiency fractures using a fluoroscopy-based navigation system

Journal of Spinal Disorders & Techniques
Ioannis D PapanastassiouFrank D Vrionis

Abstract

Surgical technique article with retrospective case series. Sacral insufficiency fractures are commonly encountered in oncologic patients and constitute a cause for persistent lower back and pelvic pain. The aim of this study is to describe the modified technique of navigated percutaneous sacroiliac (SI) fixation using multiple long screws per level that cross both SI joints and engage bilateral iliac bones; furthermore to evaluate its safety and efficacy in oncologic patients with sacral insufficiency fractures. Six oncologic patients (3 male, 3 female, mean age: 58.8 y) with sacral insufficiency fractures who had undergone additional radiation therapy were operated with navigated percutaneous fixation. Two patients had failed preoperative sacroplasty and 1 had failed SI pinning. Eighteen SI screws were placed (15 at S1 level and 3 at S2). In the majority of cases the screws were long enough to engage bilateral ilium and sacrum. Additionally, 1 patient underwent percutaneous iliolumbar instrumentation and in 4 patients we performed concomitant sacroplasty or polymethylmethacrylate screw augmentation. The patients were followed for 18.8 months in average (range: 12-30 mo). Outcome was assessed using the Karnofsky Performance Sta...Continue Reading

Citations

Nov 19, 2015·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·M A KönigBronek M Boszczyk
Apr 4, 2015·Journal of Neurosurgery. Spine·Hasan A ZaidiCurtis A Dickman
May 12, 2016·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·M A KönigC M L Werner
Aug 10, 2016·International Journal of Computer Assisted Radiology and Surgery·Savyasachi C ThakkarErik A Hasenboehler
Oct 30, 2019·World Neurosurgery·Giorgio SantoroMaurizio Domenicucci

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