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Related Experiment Video

Updated: Jun 2, 2026

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The flying buttress construct for posterior spinopelvic fixation: a technical note.

Barend J van Royen1, Martijn van Dijk, Dirk Ph van Oostveen

  • 1Department of Orthopaedic Surgery VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. bj.vanroyen@vumc.nl.

Scoliosis
|April 15, 2011
PubMed
Summary

The novel Flying Buttress technique offers a new solution for challenging spinopelvic fixation in spinal deformity surgery. This method simplifies connecting posterior rods to iliac screws, regardless of patient-specific angles.

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Area of Science:

  • Spine Surgery
  • Orthopedic Surgery
  • Biomechanical Engineering

Background:

  • Spinopelvic fixation in spinal deformity remains a surgical challenge.
  • Current techniques for posterior rod-to-iliac screw assembly are often technically difficult.
  • Existing methods struggle with patient-specific angles, requiring rod bending or offset connectors.

Purpose of the Study:

  • To introduce and evaluate a new spinopelvic fixation system.
  • To address the technical difficulties in connecting posterior rod constructs to iliac screws.
  • To provide an alternative fixation method for complex spinal deformities.

Main Methods:

  • A novel "Flying Buttress" spinopelvic fixation system was adopted.
  • Iliac screws are connected to the posterior thoracolumbar rod construct using open angled parallel connectors.

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  • This system allows side-to-side connection independent of the angle between the rod and iliac screw.

    • Main Results:

    • The technique was illustrated in three distinct patient cases.
    • Clinical details, radiographic findings, and surgical techniques were presented.
    • The construct's resemblance to architectural flying buttresses was noted for its lateral support function.

    Conclusions:

    • The Flying Buttress construct presents a viable alternative for spinopelvic fixation.
    • It is particularly useful when coronal or sagittal balance is difficult to achieve.
    • This method may be beneficial in revision surgeries or cases with pelvic obliquity.