COMPARISON OF X-RAY AND CT METHODS FOR ASSESSING SACRAL SHAPE VARIANTS AND IDENTIFYING A SECURE SACROILIAC SCREW FIXATION CORRIDOR

2019 ◽  
Vol 22 (03n04) ◽  
pp. 1950007
Author(s):  
Florian Radetzki ◽  
Felix Goehre ◽  
Stefan Schwan ◽  
Andreas Wienke ◽  
Lars Jansch ◽  
...  
Keyword(s):  
Predictive Value ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Invasive Technique ◽  
Posterior Pelvic Ring ◽  
Predictive Values ◽  
X Ray ◽  
Sacroiliac Screw ◽  
Screw Insertion ◽  
Sacroiliac Screw Fixation

Sacroiliac screw fixation is the only minimally invasive technique for stabilizing unstable posterior pelvic ring fractures. X-ray/CT methods identify sacral shape variants, which influence screw fixation feasibility at sacral segment S1. As no reliability analysis was previously published, this study analyzed four X-ray/CT-based screw corridor evaluation methods. CT datasets of 80 human pelvises (♂[Formula: see text][Formula: see text], ♀[Formula: see text][Formula: see text], [Formula: see text] years, [Formula: see text][Formula: see text]cm, [Formula: see text][Formula: see text]kg) were used. CTs were post-processed using Amira 5.2 software to generate 3D models and analyzed for S1 transverse 7.3[Formula: see text]mm screw corridors using a C++ program. CT-slices and radiograph-like images were generated per each classification’s requirements. Five surgeons independently assessed sacral shape and transverse screw insertion feasibility. Sensitivity, specificity, and positive/negative predictive values were calculated. C++ analysis indicated feasible screw insertion in 66 cases (82%). Sensitivities were 86% (Mendel), 75% (Routt), 74% (Carlson), and 67% (Kim). Specificities were 73% (Mendel) and 79% (Kim). Mean positive predictive value spanned from 54.6% (Mendel) to 26.2% (Carlson); negative predictive value spanned from 94.5% (Kim) to 90.4% (Carlson). No significant differences existed between surgeons. Mendel’s classification provides reliable and reproducible assessment via the lateral sacral triangle, without additional CTs like Carlson or Routt or the subjectivity of Kim’s method.

scholarly journals Posterior pelvic ring fractures: Closed reduction and percutaneous CT-guided sacroiliac screw fixation

1997 ◽  
Vol 20 (4) ◽  
pp. 285-294 ◽  
Author(s):  
Augustinus Ludwig Jacob ◽  
Peter Messmer ◽  
Klaus-Wilhelm Stock ◽  
Norbert Suhm ◽  
Bernard Baumann ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Screw Fixation ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring ◽  
Ct Guided ◽  
Sacroiliac Screw ◽  
Pelvic Ring Fractures ◽  
Sacroiliac Screw Fixation

scholarly journals Two-Dimensional Visualization of the Three-Dimensional Planned Sacroiliac Screw Corridor with the Slice Fusion Method

2021 ◽  
Vol 10 (2) ◽  
pp. 184
Author(s):  
Maximilian Kerschbaum ◽  
Siegmund Lang ◽  
Florian Baumann ◽  
Volker Alt ◽  
Michael Worlicek
Keyword(s):  
Pelvic Ring ◽  
Three Dimensional ◽  
Fusion Method ◽  
Two Dimensional ◽  
Posterior Pelvic Ring ◽  
Simple Method ◽  
Sacroiliac Screw ◽  
Screw Insertion ◽  
Multiplanar Reconstructions ◽  
Screw Position

Insertion of sacro-iliac (SI) screws for stabilization of the posterior pelvic ring without intraoperative navigation or three-dimensional imaging can be challenging. The aim of this study was to develop a simple method to visualize the ideal SI screw corridor, on lateral two-dimensional images, corresponding to the lateral fluoroscopic view, used intraoperatively while screw insertion, to prevent neurovascular injury. We used multiplanar reconstructions of pre- and postoperative computed tomography scans (CT) to determine the position of the SI corridor. Then, we processed the dataset into a lateral two-dimensional slice fusion image (SFI) matching head and tip of the screw. Comparison of the preoperative SFI planning and the screw position in the postoperative SFI showed reproducible results. In conclusion, the slice fusion method is a simple technique for translation of three-dimensional planned SI screw positioning into a two-dimensional strict lateral fluoroscopic-like view.

scholarly journals Tape suture for stabilization of incomplete posterior pelvic ring fractures—biomechanical analysis of a new minimally invasive treatment for incomplete lateral compression pelvic ring fractures

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Christopher Alexander Becker ◽  
Adrian Cavalcanti Kussmaul ◽  
Eduardo Manuel Suero ◽  
Markus Regauer ◽  
Matthias Woiczinski ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Tracking System ◽  
Fracture Site ◽  
Biomechanical Analysis ◽  
Lateral Compression ◽  
Posterior Pelvic Ring ◽  
Sacroiliac Screw ◽  
Minimal Invasiveness ◽  
Compression Fractures ◽  
Pelvic Ring Fractures

Abstract Background Incomplete lateral compression fractures (including AO Type B2.1) are among the most common pelvic ring injuries. Although the treatment of choice remains controversial, sacroiliac (SI) screws are commonly used for the operative treatment of incomplete lateral compression fractures of the pelvic ring. However, the disadvantages of SI screws include the risk of nerve root or blood vessel injury. Recently, tape sutures have been found useful as stabilizing material for the treatment of injuries of the syndesmosis, the rotator cuff and knee ligaments. In this current study, we aimed to test the biomechanical feasibility of tape sutures to stabilize the pelvis in the setting of AO Type B2.1 injury. Methods Six human cadaveric pelvises underwent cyclic loading to compare the biomechanical stability of different osteosynthesis methods in a B2.1 fracture model. The methods tested in this experiment were a FiberTape® suture and the currently established SI screw. A 3D ultrasound tracking system was used to measure fracture fragment motion. Linear regression was used to model displacement and stiffness at the posterior and anterior pelvic ring. Results At the posterior fracture site, the FiberTape® demonstrated similar displacement (2.2 ± 0.8 mm) and stiffness (52.2 ± 18.0 N/mm) compared to the sacroiliac screw (displacement 2.1 ± 0.6 mm, P >  0.999; stiffness 50.8 ± 13.0 N/mm, P > 0.999). Considering the anterior fracture site, the FiberTape® again demonstrated similar displacement (3.8 ± 1.3 mm) and stiffness (29.5 ± 9.0 N/mm) compared to the sacroiliac screw (displacement 2.9 ± 0.8 mm, P = 0.2196; stiffness 37.5 ± 11.5 N/mm, P = 0.0711). Conclusion The newly presented osteosynthesis, the FiberTape®, shows promising results for the stabilization of the posterior pelvic ring in AO Type B2.1 lateral compression fractures compared to a sacroiliac screw osteosynthesis based on its minimal-invasiveness and the statistically similar biomechanical properties.

Robot-assisted S2 screw fixation for posterior pelvic ring injury

Injury ◽  
2020 ◽  
Author(s):  
Junqiang Wang ◽  
Teng Zhang ◽  
Wei Han ◽  
KeHan Hua ◽  
Xinbao Wu
Keyword(s):  
Screw Fixation ◽  
Pelvic Ring ◽  
Pelvic Ring Injury ◽  
Robot Assisted ◽  
Posterior Pelvic Ring ◽  
Posterior Pelvic Ring Injury

The potential biomechanical advantage of lag by technique screw fixation of the posterior pelvic ring

2020 ◽  
Vol 30 (6) ◽  
pp. 1045-1048
Author(s):  
Michael Maher ◽  
Todd H. Baldini ◽  
Joshua A. Parry ◽  
Cyril Mauffrey
Keyword(s):  
Screw Fixation ◽  
Pelvic Ring ◽  
Posterior Pelvic Ring
Sign in / Sign up

Export Citation Format

Share Document