Document Type : RESEARCH PAPER
Authors
1
Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
3
Orthopaedics Department,Taleghani Hospital,Shahid Beheshti University Of Medicine Science,Tehran,Iran
4
Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
5
Department of Orthopedic and Trauma Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.22038/abjs.2024.77855.3589
Abstract
Introduction: Percutaneous sacroiliac screw fixation is a well-defined surgery method to fix unstable fractures of the pelvic ring with fewer post-surgical complications. However, the complex anatomy of the mentioned area is responsible for a big challenge during percutaneous sacroiliac screw fixation. The present study aimed to investigate a modified screw insertion method using two views of fluoroscopy X-ray instead of the prior three views to reduce the operation time and radiation exposures.
Methods: The present study was performed on ten radiopaque plastic pelvic models (including 20 half pelvis) during simulated surgical procedures. Of 20 screws, ten screws were inserted using conventional method with navigation of three fluoroscopy views (Group A). The remaining ten screws were inserted using the modified method with navigation of two fluoroscopy views, including just outlet and inlet views, without taking a lateral view, based on our theory and order of fluoroscopy performed (Group B). Following screw insertion, the accuracy of screw locations was evaluated using computed tomography (CT) scan, and the duration of operations and radiation exposures were compared between the two surgery methods at the end of the study.
Results: In both groups, nine screws (90%) were located correctly, and one screw (10%) perforated the anterior wall of the first sacral vertebrae. The mean ± SD of the duration of radiation exposure in groups A and B was 6.1 ± 1.0 min and 4.2±0.1 min, respectively (p=0.01). Moreover, the mean ± SD of operations duration in group A was 45.7 ± 5.8 min, but this value in group B was 35.5 ± 4.5, which shows a significant decrease in operation time (p=0.04).
Conclusion: Percutaneous sacroiliac screw fixation using a modified screw insertion method with just two fluoroscopy views not only has similar accuracy to conventional methods but also could decrease the operation time and following radiation exposure.
Keywords: Sacroiliac Joint; Percutaneous screw insertion; Fluoroscopy; Pelvic Imaging navigation
Levels of Evidence: IV
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