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Pelvic Fixation Construct Trends in Spinal Deformity Surgery.

Andrew F Ormseth1, Kari Odland1, Jason J Haselhuhn1

  • 1The Department of Orthopedic Surgery, University of Minnesota, 2512 South 7th Street, Suite R200, Minneapolis, MN 55455 USA.

Indian Journal of Orthopaedics
|March 28, 2024
PubMed
Summary
This summary is machine-generated.

Spine surgeons are increasingly using multiple implants for pelvic fixation in adult spinal deformity to reduce implant failure. This trend shows a significant rise in combined techniques like S2-alar-iliac screws over 12 years.

Keywords:
Adult spinal deformityIliac screwsImplant failurePelvic fixationS2AI

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Area of Science:

  • Orthopedic Surgery
  • Spinal Deformity Correction
  • Implant Technology

Background:

  • Spinopelvic fixation remains challenging in adult spinal deformity due to shear forces, complex anatomy, and bone quality.
  • Surgeons continuously seek improved fixation techniques to address these challenges.

Purpose of the Study:

  • To analyze trends in pelvic fixation techniques for adult spinal deformity over a 12-year period.
  • To evaluate the adoption of different implant constructs, including S2-alar-iliac (S2AI) screws.

Main Methods:

  • Retrospective chart review of 494 patients undergoing pelvic fixation for adult spinal deformity.
  • Patients categorized into three surgical cohorts (2010-2013, 2014-2017, 2018-2021).
  • Analysis of implant types: traditional iliac screws, stacked S2AI screws, and triangular titanium implants.

Main Results:

  • The utilization of at least two pelvic implants increased from 90.2% to 99.1% over the study period.
  • The use of S2AI screws saw a substantial 120% increase.
  • A near tenfold percentage increase in multiple bilateral implant constructs was observed in recent cohorts.

Conclusions:

  • There is a clear institutional trend towards employing multiple bilateral implant constructs for pelvic fixation in adult spinal deformity.
  • Combined techniques, such as iliac screws with S2AI screws or S2AI screws with triangular titanium implants, are increasingly used.
  • These strategies aim to mitigate implant failure in complex spinal deformity cases.