The Prevalence and Risk Factors for S2 Alar-Iliac Screw Loosening with a Minimum 2-Year Follow-up
- Author:
Hiroaki NAKASHIMA
1
;
Tokumi KANEMURA
;
Kotaro SATAKE
;
Kenyu ITO
;
Yoshimoto ISHIKAWA
;
Jun OUCHIDA
;
Naoki SEGI
;
Hidetoshi YAMAGUCHI
;
Shiro IMAGAMA
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2020;14(2):177-184
- CountryRepublic of Korea
- Language:0
-
Abstract:
Methods:This retrospective study included 35 patients (mean age, 72.8±8.0 years; male, 10; female, 25) who underwent lumbosacral fixation using SAI screws with at least 2 years of follow-up. SAI screw loosening and L5–S bony fusion were assessed using computed tomography. The period for which the screws appeared loose and the risk factors for SAI screw loosening were investigated 2 years after surgery.
Results:A total of 70 SAI screws and 70 S1 pedicle screws were inserted. Loosening was observed 0.5, 1, and 2 years after surgery in 17 (24.3%), 35 (50.0%), and 35 (50.0%) SAI screws, respectively. Bony fusion rate at L5–S was significantly lower in patients with SAI screw loosening than in those without screw loosening (65.0% vs. 93.3%, p =0.048). The score for SAI screw contact with the iliac cortical bone and the bony fusion rate at L5–S were significantly lower in the loosening group than in the non-loosening group (1.8±0.5 vs. 2.2±0.3, p <0.001, respectively). Postoperative pelvic incidence–lumbar lordosis was significantly higher in the loosening group than in the non-loosening group (7.9°±15.4° vs. 0.5°±8.7°, p =0.02, respectively).
Conclusions:SAI screw loosening is closely correlated with pseudoarthrosis at L5–S. Appropriate screw insertion and optimal lumbar lordosis restoration are important to prevent postoperative complications related to SAI screws.
