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Published on: July 15, 2021
Ilio-lumbar fixation--the Amrita technique
Narayana K Acharya1, Binod Bijukachhe, Renjit J Kumar
1Department of Orthopaedics, Amrita Institute of Medical Sciences, Cochin, Kerala, India. knacharya@hotmail.com
Study Design:
Surgical technique description.
Objective:
To describe a surgical technique of ilio-lumbar fixation with iliac screws, which attempts to overcome some of the current limitations and technical difficulties associated with this surgery.
Summary Of Background Data:
The iliac screw technique, which is the most commonly used method of ilio-lumbar fixation, has certain limitations that need special consideration. These include soft tissue coverage, improving the strength of distal anchorage, reducing hardware prominence, avoiding complex 3-dimensional rod contouring, preventing neurologic injury, and acetabular violation.
Materials And Results:
Over the past 5 years, we have used our technique in 8 patients (4 sacral tumors, 2 fracture dislocations, and 2 spinal tuberculosis). In 6 cases, the sacrum was not available for anchoring and hence was bypassed. The follow-up ranged from 3 to 54 months, and 5 patients had resumed normal activities. In 7 cases, the wound healed primarily and the solitary wound failure was in a previously irradiated skin. Other complications like neurologic deficit secondary to the procedure, acetabular violation, and implant failure were not encountered.
Conclusions:
Our technique of ilio-lumbar fixation provides a stable and simple alternative to reconstruct potentially devastating instability of the lumbosacral junction. The 2 iliac screws, when used as described, make the procedure technically easier, reduce the hardware prominence without compromising the stability to construct and provide adequate bone graft.
