Long-segment spinal fixation using pelvic screws.

Area of Science:

• Orthopedic Surgery
• Spinal Fusion
• Biomechanical Fixation

Background:

• Long spinal constructs increase stress on sacral screws, risking loosening.
• Pelvic screw fixation is an increasingly popular alternative for enhanced stability.
• It's also used when sacral fixation is contraindicated, such as in sacral tumors.

Purpose of the Study:

• To describe the technique for pelvic screw fixation.
• To review the clinical and radiographic outcomes of this fixation method.

Main Methods:

• A retrospective review of 20 consecutive patients undergoing spinal-pelvic fixation from 2004-2007.
• Patients had an average age of 58.8 years, with indications including kyphoscoliosis, tumors, and spondylolisthesis.
• Outcomes were assessed via radiographic imaging (flexion-extension X-rays, CT scans) and clinical evaluations (Odom's criteria, modified Prolo scale).

Main Results:

• Mean follow-up was 13 months. Good to excellent clinical outcomes were achieved in 58% of patients.
• Radiographic fusion was obtained in 89% of patients with available follow-up.
• One patient required pelvic screw revision, and one experienced an infection requiring hardware removal.

Conclusions:

• Pelvic screw fixation is a safe and effective method for augmenting sacral screw support in long spinal fusions.
• It provides a viable distal fixation point when sacral fixation is not possible.
• The technique is simpler than previous methods like Galveston rod fixation.