S3 Sacral-Alar Iliac Screw: A Salvage Technique for Pelvic Fixation in Complex Deformity Surgery
Author links open overlay panelTobias A.Mattei
Division of Neurological Surgery, Saint Louis University, Saint Louis University Hospital, St. Louis, Missouri, USA
Received 29 January 2020, Accepted 4 March 2020, Available online 16 March 2020.
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https://doi.org/10.1016/j.wneu.2020.03.025Get rights and content
Sacral-alar iliac (SAI) screws constitute a relatively new technique for pelvic fixation. Since their initial description in 2007, SAI screws have gained wide popularity among the spine surgery community. In 2013, we first described the possibility of using both S1 and S2 SAI screws for pelvic fixation in revision surgeries for adult degenerative scoliosis. Although a previous radiological study has suggested the feasibility of S3 and S4 SAI screws, to the best of our knowledge, there has been no report in the literature on the clinical use of such techniques. In this brief technical note, we present the first clinical report of the use of S3 SAI screws as a salvage method for pelvic fixation in a patient with suboptimal anatomy that prevented proper placement of S1 and S2 SAI screws. We also discuss the recommended anatomical entry points and trajectory of such screws.
Author links open overlay panelTobias A.Mattei
Division of Neurological Surgery, Saint Louis University, Saint Louis University Hospital, St. Louis, Missouri, USA
Received 29 January 2020, Accepted 4 March 2020, Available online 16 March 2020.
crossmark-logo
Show less
https://doi.org/10.1016/j.wneu.2020.03.025Get rights and content
Sacral-alar iliac (SAI) screws constitute a relatively new technique for pelvic fixation. Since their initial description in 2007, SAI screws have gained wide popularity among the spine surgery community. In 2013, we first described the possibility of using both S1 and S2 SAI screws for pelvic fixation in revision surgeries for adult degenerative scoliosis. Although a previous radiological study has suggested the feasibility of S3 and S4 SAI screws, to the best of our knowledge, there has been no report in the literature on the clinical use of such techniques. In this brief technical note, we present the first clinical report of the use of S3 SAI screws as a salvage method for pelvic fixation in a patient with suboptimal anatomy that prevented proper placement of S1 and S2 SAI screws. We also discuss the recommended anatomical entry points and trajectory of such screws.
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