French National Academy of Medicine, Paris, France.
Pediatric Orthopedic Department, Assistance Publique Hôpitaux de Paris, Necker Hospital, Paris Descartes University, 149 rue de Sèvres, 75015, Paris, France.
Spine Deform. 2021 May;9(3):665-670. doi: 10.1007/s43390-020-00263-6. Epub 2021 Jan 5.
Ilio-sacral screw fixation for treatment of spinal deformities with pelvic obliquity was used from more than 40 years in our department of pediatric orthopedics. Despite trying all the other systems published in the literature, the authors came back to iliosacral screw to address the pelvic fixation. Keeping the same anatomical and biomechanical principles, with no damage of the SI joint, they improve the technology over time, to allow an easy use. The fear about the precise insertion necessary to prevent any root irritation is now greatly reduced thanks to the modern navigation. The history of the establishment and the advantages of this technique are explained based on more than 250 cumulative cases with an excellent correction of the pelvic obliquity, without any case of complete pull out of the ilio-sacral screw. A very low rate of nonunion thanks to the 3D adaptation of the balance in erect standing or sitting posture of the patient, thanks to the motion of the intact SI joint, and the small sagittal motion existing in the linkage screw/connector. All this comparing favorably to the other techniques published in the current literature.
我们小儿矫形外科部门使用经髂骨-骶骨螺钉固定治疗骨盆倾斜的脊柱畸形已经超过 40 年。尽管尝试了文献中公布的所有其他系统，作者还是回到经髂骨-骶骨螺钉来解决骨盆固定问题。作者保留了相同的解剖学和生物力学原则，不损伤骶髂关节，随着时间的推移不断改进技术，使其更易于使用。由于现代导航技术的发展，对精确插入以防止任何神经根刺激的担忧现在大大减少。基于超过 250 例累积病例，详细说明了该技术的建立历史和优势，这些病例骨盆倾斜得到了极好的矫正，没有一例出现经髂骨-骶骨螺钉完全拔出的情况。由于完整的骶髂关节的运动以及连接螺钉/连接器中存在的小矢状运动，患者在直立或坐姿时平衡的 3D 适应性非常好，非融合率非常低。所有这些都优于当前文献中公布的其他技术。
