The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Percutaneous Sacroiliac Screw Fixation: A Modified Screw Insertion Method Using Just 2 Fluoroscopy Views

Document Type : RESEARCH PAPER

Authors
Farshid Dehkhoda 1
Alireza Manafi Rasi 1
Reza Zandi 2
Maryam Abedi 3
Seyed Shayan Ebadi 1
1 Department of Orthopedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Department of Orthopedics, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Pathology, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
10.22038/abjs.2024.77855.3589
Abstract
Objectives: Percutaneous sacroiliac screw fixation (PSSF) is a well-defined method of surgery to fix unstable fractures of the pelvic ring with fewer post-surgical complications. However, the complex anatomy of the mentioned area makes PSSF a formidable challenge. 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 duration of operations and radiation exposures.
Methods: The present study was performed on 10 radiopaque plastic pelvic models (including 20 half pelvis) during simulated surgical procedures. Of the 20 screws, 10 were inserted using the conventional method with the navigation of three fluoroscopy views (Group A). The remaining 10 were inserted using the modified method with the navigation of two fluoroscopy views, including just the outlet and inlet views, without taking the lateral view, based on our theory and order of fluoroscopy (Group B). Following screw insertion, the accuracy of screw locations was evaluated using a 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 vertebra. 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 operation duration in group A was 45.7±5.8 min, but this value in group B was 35.5±4.5, which showed a significant decrease in operation duration (P=0.04).).
Conclusion: PSSF using a modified screw insertion method with just two fluoroscopy views not only had similar accuracy to conventional methods but also could decrease operation time and the following radiation exposure.
        Level of evidence: IV
Keywords
Fluoroscopy
Pelvic imaging navigation
Percutaneous screw insertion
Sacroiliac Joint
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 8
August 2024
Pages 574-579

  • Receive Date 06 February 2024
  • Revise Date 17 May 2024
  • Accept Date 18 May 2024