Navigated percutaneous pelvic sacroiliac screw fixation: experimental comparison of accuracy between fluoroscopy and...

Percutaneous sacroiliac screw fixation is technically demanding and can result in complications mainly related to imaging problems. Furthermore, the conventional technique performed using fluoroscopic control is associated with a long radiation exposure. The purpose of this study was to evaluate the accuracy of two navigation technologies used in traumatology; fluoroscopy and Iso-C3D navigation. A total of 40 screws were placed (20 with Iso-C3D, 20 with 2D fluoroscopy) at levels S1 and S2. With both technologies, all S1 screws could be placed correctly, but four (10%) incorrect placements were seen at S2 with fluoroscopy navigation. With all Iso-C3D navigated drillings, no perforation was seen. Iso-C3D navigation therefore proved superior to 2D fluoroscopy navigation for sacroiliac screw fixation in an experimental set-up designed to assess accuracy.