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Updated: Jun 5, 2026
A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Sacropelvic fixation: two case reports of a new percutaneous technique
Christopher T Martin1, Timothy F Witham, Khaled M Kebaish
1Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Study Design:
Case report.
Objective:
To describe a new method of minimally invasive percutaneous sacropelvic fixation and to report on its use in two patients.
Summary Of Background Data:
The Galveston and iliac screw techniques are in widespread use for sacropelvic fixation, but neither technique is amenable to a percutaneous approach. The S2-alar-iliac technique is a recently described method that involves finding a pathway from the S2 sacrum into the ilium with fluoroscopy. We describe a new minimally invasive approach for this technique that allows percutaneous insertion of the screws and spinal construct.
Methods:
A 69-year-old female with follicular thyroid carcinoma metastatic to the sacrum and a 55-year-old male with a sacral fracture were both treated with the new technique. We have described this new technique and reviewed the patients' clinical history, radiographic imaging, and outcomes.
Results:
Stable fixation was achieved in both cases. Blood loss was 70 and 45 mL, respectively. There were no intraoperative complications.
Conclusion:
To our knowledge, this report is the first description of a percutaneous minimally invasive approach to sacropelvic fixation in spinal fusion surgery. It is likely that this minimally invasive technique will result in less blood loss, lower infection rates, and a more rapid postoperative recovery than that associated with the more widely used open techniques.
