Freehand S2 Alar-Iliac Screw Placement Using K-Wire and Cannulated Screw: Technical Case Series
10.3340/jkns.2016.1212.008
- Author:
Ho Yong CHOI
1
;
Seung Jae HYUN
;
Ki Jeong KIM
;
Tae Ahn JAHNG
;
Hyun Jib KIM
Author Information
1. Department of Neurosurgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
- Publication Type:Original Article
- Keywords:
S2 alar-iliac screw;
Sacropelvic fixation;
Free hand technique;
Cannulated screw
- MeSH:
Hand;
Humans;
Ilium;
Sacroiliac Joint;
Spine
- From:Journal of Korean Neurosurgical Society
2018;61(1):75-80
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Among the various sacropelvic fixation methods, S2 alar-iliac (S2AI) screw fixation has several advantages compared to conventional iliac wing screw. However, the placement of S2AI screw still remains a challenge. The purpose of this study was to describe a novel technique of free hand S2AI screw insertion using a K-wire and cannulated screw, and to evaluate the accuracy of the technique.METHODS: S2AI screw was inserted by free hand technique in sixteen consecutive patients without any fluoroscopic guidance. The gearshift was advanced to make a pilot hole passing through the sacroiliac joint and directing the anterior inferior iliac spine. A K-wire was placed through the pilot hole. After introducing a cannulated tapper along with the K-wire, a cannulated S2AI screw was installed over the K-wire.RESULTS: Thirty-three S2AI screws were placed in sixteen consecutive patients. Thirty-two screws were cannulated screws, and one screw was a conventional non-cannulated screw. Thirty out of 32 (93.8%) cannulated screws were accurately positioned, whereas two cannulated screws and one non-cannulated screw violated lateral cortex of the ilium.CONCLUSION: The technique using K-wire and cannulated screw can provide accurate placement of free hand S2AI screw.