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Minimally Invasive Techniques for Iliac Bolt Placement: 2-Dimensional Operative Video
Travis Hamilton1, Mohamed Macki1, Thomas M Zervos1
1Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
Operative Neurosurgery (Hagerstown, Md.)
|February 8, 2021
Summary
Minimally invasive surgery (MIS) for spinal fusion now includes a technique for placing iliac bolts. This method uses image guidance for precise screw placement, minimizing soft tissue dissection and improving pelvic fixation.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Minimally invasive surgery (MIS) is increasingly popular for spinal diseases.
- Advanced spinal conditions often require large fusion constructs and iliac bolt fixation.
- Technical details for MIS iliac bolt placement are lacking in current literature.
Purpose of the Study:
- To describe a minimally invasive technique for placing iliac bolts.
- To demonstrate the use of intraoperative imaging for accurate screw placement.
- To provide technical notes for MIS multisegment spinal fixation.
Main Methods:
- A mini-open approach was used, preserving fascial planes.
- Image guidance (O-Arm Surgical Imaging System) directed pedicle screw and iliac bolt placement.
- Navigated awl-tap guided 8.5 mm x 90 mm iliac screws into the bone.
Main Results:
- The technique allowed for multilevel instrumentation and fixation to the ilium.
- Minimally invasive placement of iliac bolts was successfully achieved.
- The approach minimized dissection of posterior pelvic soft tissues.
Conclusions:
- This minimally invasive technique facilitates secure pelvic fixation in complex spinal fusions.
- Image-guided MIS iliac bolt placement is a viable alternative to open surgery.
- The described method enhances fixation while reducing surgical trauma.
