Department of Orthopaedics, Division of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Orthopaedics and Traumatology, the First Affiliated Hospital of University of South China, Hengyang, China.
World Neurosurg. 2022 Feb;158:e1002-e1010. doi: 10.1016/j.wneu.2021.12.016. Epub 2021 Dec 8.
The S2-alar-iliac (S2AI) screws have been described as an alternative method for lumbosacropelvic fixation in place of iliac screws. However, the clinical effect of the short-segment S2AI screw fixation technique in the treatment of unstable posterior pelvic ring injuries remains unclear. In this study, we report the preliminary clinical results of the internal fixation connecting a S2-alar-iliac screw and a S1 pedicle screw (i.e., S2AI-S1 fixation) in the treatment of unstable pelvic posterior ring injuries.
Twenty-five patients with unstable posterior pelvic ring injury were treated with S2AI-S1 fixation from February 2019 to June 2020. The incision length, surgical time, blood loss, frequency of intraoperative fluoroscopy, quality of reduction, complications, and functional outcome were analyzed.
A total of 29 groups of S2AI-S1 fixation were used in 25 patients. The mean incision length was 8.3 (6.2 - 10.3) cm, mean operative time was 86.4 (60 - 142) minutes, mean frequency of intraoperative fluoroscopy was 7.9 (4 - 12) times, and mean blood loss was 148 (50 - 500) mL. The mean postoperative follow-up time was 17.8 (10 - 26) months. The satisfaction rate of pelvic reduction quality was 25/29, and the satisfactory rate of functional outcome was 23/25. There were no obvious signs of screw prominence, screw loosening, or implant failure.
The case series presented in this study show the successful use of S2AI-S1 fixation to treat unstable posterior pelvic ring injuries. The S2AI-S1 fixation, not including the lumbar spine in the fixation range, is a simple, safe, and effective fixation method.
S2 骶髂（S2AI）螺钉已被描述为替代髂骨螺钉进行腰骶骨盆固定的一种方法。然而，短节段 S2AI 螺钉固定技术治疗不稳定骨盆后环损伤的临床效果尚不清楚。本研究报告了 S2AI-S1 螺钉固定（即 S2AI-S1 固定）治疗不稳定骨盆后环损伤的初步临床结果。
2019 年 2 月至 2020 年 6 月，我们采用 S2AI-S1 固定治疗 25 例不稳定骨盆后环损伤患者。分析切口长度、手术时间、失血量、术中透视次数、复位质量、并发症和功能结果。
25 例患者共使用 29 组 S2AI-S1 固定。平均切口长度为 8.3（6.2-10.3）cm，平均手术时间为 86.4（60-142）分钟，平均术中透视次数为 7.9（4-12）次，平均失血量为 148（50-500）ml。平均术后随访时间为 17.8（10-26）个月。骨盆复位质量满意度为 25/29，功能结果满意度为 23/25。无明显螺钉突出、螺钉松动或植入物失败迹象。
本研究中的病例系列表明，S2AI-S1 固定成功用于治疗不稳定骨盆后环损伤。S2AI-S1 固定不包括腰椎固定范围，是一种简单、安全、有效的固定方法。
