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Related Experiment Video

Updated: Nov 15, 2025

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Tear-drop technique in iliac screw placement: a technical analysis.

Stephan Nowak1, Jonas Müller2, Martin E Weidemeier2

  • 1Universitätsmedizin Greifswald, Klinik und Poliklinik für Neurochirurgie, Sauerbruchstraße, 17475, Greifswald, Germany. stephan.nowak@med.uni-greifswald.de.

Acta Neurochirurgica
|March 6, 2021
PubMed
Summary

This study presents a fast, low-exposure X-ray-guided tear-drop technique for iliac screw placement in sacropelvic fixation. The technique achieved 98.1% correct screw placement, offering a reliable alternative to navigated methods.

Keywords:
Iliac screwScrew placementSpinal surgerySpineSurgerySurgical techniqueTear-dropX-ray

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Area of Science:

  • Spine surgery
  • Orthopedic instrumentation
  • Radiological guidance

Background:

  • Lumbosacral instrumentation presents challenges due to complex anatomy and biomechanics.
  • Iliac screw placement can be guided by navigation or X-ray verification.
  • Open, low-exposure X-ray-guided techniques offer potential advantages.

Purpose of the Study:

  • To demonstrate a fast and reliable open, low-exposure X-ray-guided technique for iliac screw placement.
  • To evaluate the efficacy of the tear-drop technique for sacropelvic fixation.

Main Methods:

  • The tear-drop technique was used for sacropelvic fixation in 48 patients between October 2016 and August 2019.
  • Open screw insertion utilized an X-ray converter (25-30° angulation) targeting the posterior superior iliac spine.
  • Intraoperative 3D scans verified correct screw placement.

Main Results:

  • A total of 95 iliac screws were placed using the tear-drop technique.
  • The technique demonstrated a high success rate, with 98.1% of screws correctly placed.

Conclusions:

  • The tear-drop technique consistently achieved proper screw positioning, confirmed by intraoperative 3D scans.
  • This X-ray-guided method is a viable alternative to navigated screw placement in sacropelvic fixation.