Spinal instrumentation for sacral-pelvic fixation: a biomechanical comparison between constructs ending with either S2 bicortical, bitriangulated screws or iliac screws

Journal of Spinal Disorders & Techniques
Jin-Hwan KimWilliam C Hutton

Abstract

A biomechanical study of 2 fixation techniques for lumbosacral fixation. To evaluate 2 techniques, one using S1 screws combined with bicortical, bitriangulated (BCBT) S2 screws, and the other using S1 screws combined with iliac screws. Common to the 2 techniques of sacral-pelvic fixation is S1 pedicle screws; the difference lies between S2 screws versus iliac screws. Iliac screws are clinically effective, yet present clinical disadvantages that S2 screws can potentially obviate, for example, wide dissection, soft tissue coverage, crossing the sacroiliac joint, and interference with bone graft harvesting. In an effort to optimize S2 fixation, we have used a BCBT S2 technique. Eight fresh human sacral-pelvic specimens were harvested (average age 78.7 y; bone density 0.75 g/cm2). Screws were placed bilaterally: (1) at S1: 7.5 mm diameter screws were placed bicortical; (2) at S2: 7.5 mm diameter by 60 mm long screws were placed bicortical and bitriangulated; (3) the ilium received 7.5 mm diameter by 80-mm-long screws. Sacral-pelvic constructs were assembled and biomechanical stiffness testing was performed. The stiffness in each loading mode was calculated. After the stiffness tests were completed, each BCBT S2 screw and each iliac...Continue Reading

Citations

Mar 23, 2013·Operative Orthopädie und Traumatologie·H KollerO Meier
May 3, 2013·Archives of Orthopaedic and Trauma Surgery·Jingchen LiuQingsan Zhu
Mar 19, 2013·Journal of Neurosurgery. Spine·Wilson Z RayAndrew T Dailey
Apr 29, 2014·Journal of Neurosurgery. Spine·Keitaro MatsukawaKoichi Nemoto
Jul 19, 2013·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Hiroyuki Yoshihara

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