Bone cement filling combined with lumbo‐iliac screw internal fixation in the treatment of benign sacroiliac joint tumours

2021 ◽  
Author(s):  
Feifei Pu ◽  
Jianxiang Liu ◽  
Zhicai Zhang ◽  
Baichuan Wang ◽  
Zengwu Shao
Keyword(s):  
Internal Fixation ◽  
Bone Cement ◽  
Sacroiliac Joint ◽  
Iliac Screw

The degenerative changes of the sacroiliac joint after S2 alar-iliac screw placement

2021 ◽  
pp. 1-7
Author(s):  
Norimasa Ikeda ◽  
Shunsuke Fujibayashi ◽  
Bungo Otsuki ◽  
Kazutaka Masamoto ◽  
Takayoshi Shimizu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bone Formation ◽  
Sacroiliac Joint ◽  
Safe Procedure ◽  
Multivariate Logistic Regression ◽  
Age At Surgery ◽  
Iliac Screw ◽  
New Onset

OBJECTIVE The goal of this study was to investigate clinical outcomes and risk factors for the progression of sacroiliac joint (SIJ) degeneration and bone formation after S2 alar-iliac screw (S2AIS) insertion. METHODS Using preoperative and follow-up CT scan findings (median follow-up 26 months, range 16–43 months), the authors retrospectively studied 100 SIJs in 50 patients who underwent S2AIS placement. The authors measured the progression of SIJ degeneration and bone formation after S2AIS insertion, postoperative new-onset SIJ pain, S2AIS-related reoperation, and instrumentation failures. Stepwise multivariate logistic regression modeling was performed to clarify the risk factors associated with the progression of SIJ degeneration. RESULTS Significant progression of SIJ degeneration was observed in 10% of the group with preoperative SIJ degeneration (p = 0.01). Bone formation was observed in 6.9% of joints. None of the patients with these radiographic changes had new-onset SIJ pain or underwent reoperation related to instrumentation failures. Multivariate logistic regression analysis revealed that preoperative SIJ degeneration (p < 0.01) and a young age at surgery (p = 0.03) significantly affected the progression of SIJ degeneration. CONCLUSIONS The progression of SIJ degeneration and bone formation neither led to major screw-related complications nor affected the postoperative clinical course during the median follow-up period of 26 months. Although S2AIS insertion is a safe procedure for most patients, the results of this study suggested that preoperative degeneration and younger age at surgery affected SIJ degeneration after S2AIS insertion. Further long-term observation may reveal other effects of S2AIS insertion on SIJ degeneration.

A biomechanical investigation of the sacroiliac joint in the setting of lumbosacral fusion: impact of pelvic fixation versus sacroiliac joint fixation

2019 ◽  
Vol 31 (4) ◽  
pp. 562-567 ◽  
Author(s):  
Harry Mushlin ◽  
Daina M. Brooks ◽  
Joshua Olexa ◽  
Bryan J. Ferrick ◽  
Stephen Carbine ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Screw Fixation ◽  
Intact Specimen ◽  
Lumbosacral Fusion ◽  
Pelvic Fixation ◽  
Biomechanical Investigation ◽  
Flexion Extension ◽  
Iliac Screw ◽  
Sacroiliac Fusion ◽  
Bending Modes

OBJECTIVEThe sacroiliac joint (SIJ) is a known source of low-back pain. Randomized clinical trials support sacroiliac fusion over conservative management for SIJ dysfunction. Clinical studies suggest that SIJ degeneration occurs in the setting of lumbosacral fusions. However, there are few biomechanical studies to provide a good understanding of the effect of lumbosacral fusion on the SIJ. In the present study, researchers performed a biomechanical investigation to discern the effect of pelvic versus SIJ fixation on the SIJ in lumbosacral fusion.METHODSSeven fresh-frozen human cadaveric specimens were used. There was one intact specimen and six operative constructs: 1) posterior pedicle screws and rods from T10 to S1 (PS); 2) PS + bilateral iliac screw fixation (BIS); 3) PS + unilateral iliac screw fixation (UIS); 4) PS + UIS + 3 contralateral unilateral SIJ screws (UIS + 3SIJ); 5) PS + 3 unilateral SIJ screws (3SIJ); and 6) PS + 6 bilateral SIJ screws (6SIJ). A custom-built 6 degrees-of-freedom apparatus was used to simulate three bending modes: flexion-extension (FE), lateral bending (LB), and axial rotation (AR). Range of motion (ROM) was recorded at L5–S1 and the SIJ.RESULTSAll six operative constructs had significantly reduced ROM at L5–S1 in all three bending modes compared to that of the intact specimen (p < 0.05). In the FE mode, the BIS construct had a significant reduction in L5–S1 ROM as compared to the other five constructs (p < 0.05). SIJ ROM was greatest in the FE mode compared to LB and AR. Although the FE mode did not show any statistically significant differences in SIJ ROM across the constructs, there were appreciable differences. The PS construct had the highest SIJ ROM. The BIS construct reduced bilateral SIJ ROM by 44% in comparison to the PS construct. The BIS and 6SIJ constructs showed reductions in SIJ ROM nearly equal to those of the PS construct. UIS and 3SIJ showed an appreciable reduction in unfused SIJ ROM compared to PS.CONCLUSIONSThis investigation demonstrated the effects of various fusion constructs using pelvic and sacroiliac fixation in lumbosacral fusion. This study adds biomechanical evidence of adjacent segment stress in the SIJ in fusion constructs extending to S1. Unilateral pelvic fixation, or SIJ fusion, led to an appreciable but nonsignificant reduction in the ROM of the unfused contralateral SIJ. Bilateral pelvic fixation showed the greatest significant reduction of movement at L5–S1 and was equivalent to bilateral sacroiliac fusion in reducing SIJ motion.

scholarly journals Clinical outcomes of giant cell tumor of bone treated with bone cement filling and internal fixation, and oral bisphosphonates

2012 ◽  
Vol 5 (2) ◽  
pp. 447-451 ◽  
Author(s):  
XIUCHUN YU ◽  
MING XU ◽  
SONGFENG XU ◽  
QING SU
Keyword(s):  
Internal Fixation ◽  
Bone Cement ◽  
Giant Cell Tumor ◽  
Giant Cell ◽  
Clinical Outcomes ◽  
Cell Tumor ◽  
Oral Bisphosphonates

scholarly journals Severe pathological fractures caused by vertebral hemangiomas with posterior decompression, bone cement augmentation and internal fixation

2016 ◽  
Vol 102 (4) ◽  
pp. 489-494 ◽  
Author(s):  
C. Li ◽  
H.-B. Zhang ◽  
H. Zhang ◽  
Q. Li ◽  
J. Zhang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Cement ◽  
Cement Augmentation ◽  
Posterior Decompression ◽  
Pathological Fractures ◽  
Vertebral Hemangiomas

scholarly journals Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory

2020 ◽  
pp. 219256822090303
Author(s):  
Yasunori Tatara ◽  
Takanori Niimura ◽  
Tatsuhiro Sekiya ◽  
Hisanori Mihara
Keyword(s):  
Sacroiliac Joint ◽  
Screw Placement ◽  
Anatomical Landmarks ◽  
Related Complication ◽  
Screw Insertion ◽  
Iliac Screw ◽  
The Individual ◽  
The Right ◽  
Navigation Software ◽  
The Ideal

Study Design: A novel technique for S2-alar-iliac (S2AI) screw placement was analyzed. Objectives: Accurate confirmation of the S2AI screw trajectory with free-hand techniques is not simple, although some anatomical landmarks have been reported. To overcome the drawback, we aimed to introduce our technique for S2AI screw placement assisted with a guidewire using a new anatomical landmark. Methods: A total of 104 S2AI screws of 52 patients who underwent S2AI screw placement were investigated. Navigation software was used to simulate S2AI screw placement preoperatively. Screw placement was performed with the nonfluoroscopic free-hand technique. In this technique, a guidewire is inserted into the ilium from the extra-articular portion of the sacroiliac joint just lateral to the ideal screw entry point toward the tip of the greater trochanter and guides the screw trajectory. If the direction of the guidewire is satisfactory, all procedures of screw insertion are performed accordingly. The screw accuracy was assessed with computed tomography. Results: The modal size of the screw was 9.5 mm × 90 mm. The average horizontal angle was 42.0° (SD = 5.1°) on the right and 40.7° (SD = 4.7°) on the left. Of the 104 screws, 4 screws (3.9%) breached dorsally. No screw-related complication was observed. Conclusions: Because the guidewire can be inserted at an angle according to the individual morphology of the sacroiliac joint, it will be a reliable guide for the screw trajectory. This technique with a guidewire would help improve the accuracy of S2AI screw placement.

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