Hasan Muhammed Yaser, Liu Gabriel
University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, National University Hospital, Singapore.
J Neurosurg Spine. 2017 Sep;27(3):316-320. doi: 10.3171/2017.3.SPINE161293. Epub 2017 Jul 7.
The management of lumbosacral neoplastic disease can be demanding, often requiring complex reconstruction. In the context of extensive sacral involvement, the risk of iliac screw breakage is greater. Few studies advocate the use of dual iliac screw techniques to reduce implant failure. In this report, the authors have described the first case of percutaneous dual iliac screw, dual rod insertion as part of a minimally invasive spinopelvic stabilization in a patient with a sacral fracture from a paraganglionoma. The patient underwent percutaneous L-2 to ilium fixation. A dual iliac screw, dual rod construct was used for stabilizing the left lumbopelvic junction. At the 1-year follow-up, the patient remained asymptomatic, with radiographs showing no signs of instrumentation failure. Minimally invasive dual iliac screw, dual rod fixation is a viable option in cases in which additional stability is required due to extensive neoplastic disease or active individuals have increased functional demands. Short-term results in this report are encouraging; however, more research is warranted to establish the procedure's long-term safety.
腰骶部肿瘤性疾病的治疗颇具挑战性，通常需要进行复杂的重建手术。在骶骨广泛受累的情况下，髂骨螺钉断裂的风险更高。很少有研究主张采用双侧髂骨螺钉技术来减少植入物失败的情况。在本报告中，作者描述了首例经皮双侧髂骨螺钉、双棒植入术，作为一名副神经节瘤导致骶骨骨折患者微创脊柱骨盆稳定术的一部分。该患者接受了经皮L2至髂骨固定术。采用双侧髂骨螺钉、双棒结构来稳定左腰骶骨盆交界处。在1年的随访中，患者无症状，X线片显示无内固定失败迹象。对于因广泛肿瘤性疾病而需要额外稳定性或活跃个体功能需求增加的病例，微创双侧髂骨螺钉、双棒固定术是一种可行的选择。本报告中的短期结果令人鼓舞；然而，需要更多研究来确定该手术的长期安全性。
