von Glinski Alexander, Elia Christopher J, Wiginton James G, Ansari Darius, Pierre Clifford, Ishak Basem, Yilmaz Emre, Blecher Ronen, Dettori Joseph R, Hayman Erik, Schildhauer Thomas A, Oskouian Rod J, Chapman Jens R
Swedish Neuroscience Institute, Swedish Medical Center.
Seattle Science Foundation, Seattle, WA.
Clin Spine Surg. 2022 Feb 1;35(1):E127-E131. doi: 10.1097/BSD.0000000000001182.
A retrospective study.
To describe the modified iliac screw (mILS) technique and compare it to other spinopelvic fixation techniques in terms of wound healing complications, hardware prominence, and failure.
The traditional entry point of an iliac screw often causes postoperative gluteal pain from the prominent screw head. The use of an offset connector also adds a point of weakness to the construct. By choosing a different screw entry point offset connectors can be avoided, and the screw head itself is less prominent, thereby reducing postoperative discomfort.
A retrospective analysis was performed of adult patients undergoing lumbopelvic fixation (LPF) between January 2014 and June 2019. Patients were grouped into 1 of 3 groups based on the technique of pelvic fixation: S2 alar-iliac (S2AI) screw, traditional iliac screw (tILS), and mILS. The primary outcome parameter was the minimal distance from screw head to skin. Secondary outcome parameters were instrumentation loosening/failure, adjacent level fractures, pseudoarthrosis, and medial or lateral iliac screw perforation.
A total of 190 patients undergoing LPF were included in the following 3 groups: mILS group (n=113), tILS group (n=40), and S2AI group (n=37). The mean minimal distance from screw head to skin in the mILS group was 31.3 mm compared with 23.7 mm in the tILS group (P<0.00199). No statistically significant differences were found when comparing the 3 groups with respect to complications. The mILS group did not show any cases of prominent instrumentation and had the lowest rate of instrumentation failure.
The mILS technique is an acceptable alternative for LPF, offering the benefits of iliac screw fixation while avoiding offset connectors and screw prominence complications associated with tILS.
Level III.
一项回顾性研究。
描述改良髂骨螺钉（mILS）技术，并在伤口愈合并发症、内固定物突出及失败情况方面将其与其他脊柱骨盆固定技术进行比较。
传统髂骨螺钉的进针点常因螺钉头部突出导致术后臀区疼痛。使用偏置连接器也会增加结构的薄弱点。通过选择不同的螺钉进针点可避免使用偏置连接器，且螺钉头部本身突出程度较小，从而减少术后不适。
对2014年1月至2019年6月期间接受腰骶骨盆固定（LPF）的成年患者进行回顾性分析。根据骨盆固定技术将患者分为3组中的1组：S2翼髂骨（S2AI）螺钉组、传统髂骨螺钉（tILS）组和mILS组。主要结局参数为螺钉头部至皮肤的最小距离。次要结局参数为内固定物松动/失败、相邻节段骨折、假关节形成以及髂骨螺钉向内或向外穿孔。
190例接受LPF的患者被纳入以下3组：mILS组（n = 113）、tILS组（n = 40）和S2AI组（n = 37）。mILS组螺钉头部至皮肤的平均最小距离为31.3mm，而tILS组为23.7mm（P < 0.00199）。比较3组并发症时未发现统计学上的显著差异。mILS组未出现任何内固定物突出病例，且内固定失败率最低。
mILS技术是LPF的一种可接受的替代方法，在提供髂骨螺钉固定优点的同时，避免了与tILS相关的偏置连接器和螺钉突出并发症。
III级。
Zotero 插件