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S2 alar iliac screws may lead to fewer complications in lumbopelvic fixation vs iliac bolts
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Although S2 alar iliac screws and iliac bolts both improved fusion rates when used for lumbopelvic fixation, the S2 alar iliac screws led to less wound-related complications and reoperations, according to study findings.
Researchers retrospectively reviewed the medical records of patients who underwent lumbopelvic fixation with either S2 alar iliac (S2AI) screws or iliac bolts between December 2009 and March 2012. Of the 60 patients included in the study, 23 received S2AI screws. Seventeen patients received an osteotomy. Mean follow-up was 22 months.
The researchers analyzed patients’ medical records to identify clinical failure. Additionally, patients who required reoperation were compared with those who did not through the use of univariate, multivariate and survival analyses.
Results showed reoperation rates were higher in patients who received iliac bolts compared with those who received S2AI screws (13 patients vs. two patients, respectively). Kaplan-Meier analysis showed from the time of the initial placement of lumbopelvic instrumentation, the failure-free rate was 96.6% at 6 months, 87% at 1 year and 73.5% at 2 years.
Through univariate analysis, the researchers found the use of iliac bolts, absence of L5-S1 interbody graft, previous lumber fusion and pathology other than degenerative disease or scoliosis were all risk factors for unplanned reoperation. After the researchers adjusted for risk factors, multivariate analysis revealed S2AI screws were the only independent predictor for preventing unplanned reoperations.
The researchers concluded the low profile of the S2AI screws and the benefit of obviating the use of offset connectors could have additional advantages over the use of iliac bolts. – by Robert Linnehan
Disclosures: Mazur reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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