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Innovative sacropelvic fixation using iliac screws and triangular titanium implants.

Matteo Panico1,2, Ruchi D Chande3, Derek P Lindsey3

  • 1Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133, Milan, Italy. matteo.panico@polimi.it.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|September 25, 2021
PubMed
Summary

Triangular titanium implants enhance sacropelvic fixation stability in spinal deformities. These implants improve iliac screw fixation and reduce sacroiliac joint motion, offering protection for spinal hardware.

Keywords:
Iliac screwsLong thoracolumbar fixationS2 alar-iliac screwsSacropelvic fixationTriangular implants

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Area of Science:

  • Spinal surgery
  • Biomechanical engineering
  • Orthopedic implants

Background:

  • Sacropelvic fixation is crucial for severe spinal deformities.
  • Iliac screw fixation is a common method for sacropelvic fixation.
  • The stability of iliac screw fixation can be a concern.

Purpose of the Study:

  • To investigate the impact of triangular titanium implants on iliac screw fixation.
  • To determine if triangular titanium implants enhance the stability of sacropelvic fixation.

Main Methods:

  • Finite element analysis (FEA) models of T10-pelvis constructs were created.
  • Models included pedicle screws (PED), iliac screws (IL), and variations with triangular titanium implants (IL-Tri-SAI, IL-Tri-Lat).
  • Hardware stresses and range of motion at L5-S1 and the SIJ were compared across models.

Main Results:

  • Sacropelvic fixation significantly reduced L5-S1 motion (75-90%) and SIJ motion (55-80%).
  • Triangular titanium implants further decreased SIJ motion and protected iliac screw stresses.
  • All tested constructs showed lower S1 pedicle stresses compared to the PED model.

Conclusions:

  • Triangular titanium implants combined with iliac screws increase sacropelvic fixation stability.
  • These implants reduce sacroiliac joint flexibility and protect spinal hardware.
  • Further clinical studies are warranted to correlate FEA findings with patient outcomes.