Skip to main content
Journal cover image

S2-Alar-Iliac Screws are Associated with Lower Rate of Symptomatic Screw Prominence than Iliac Screws: Radiographic Analysis of Minimal Distance from Screw Head to Skin.

Publication ,  Journal Article
Ishida, W; Elder, BD; Holmes, C; Goodwin, CR; Lo, S-FL; Kosztowski, TA; Bydon, A; Gokaslan, ZL; Wolinsky, J-P; Sciubba, DM; Witham, TF
Published in: World Neurosurg
September 2016

BACKGROUND: In sacropelvic fixation, the iliac screw technique offers biomechanically strong constructs, but its disadvantages include screw prominence, wound dehiscence, and postoperative pain secondary to the high profile nature. To overcome this drawback, S2-alar-iliac (S2AI) screws were developed as an alternative technique for sacropelvic fixation. This study aimed to compare the S2AI screw technique with the iliac screw technique in terms of postoperative symptomatic screw prominence. METHODS: A retrospective review of the records of sacropelvic fusion procedures performed at a single institution between October 2010 and January 2015 identified 32 patients with 72 iliac screws and 68 patients with 148 S2AI screws, and clinical and radiographic data were collected. If a patient had wound dehiscence and/or tenderness in the buttock immediately overlying a pelvic screw head postoperatively, it was defined as symptomatic screw prominence. The minimal distance from screw head to skin (MDSS) on postoperative computed tomography scans was measured for each patient to clarify the relationship between symptomatic screw prominence and MDSS. RESULTS: Mean follow-up period was 22.0 months. There was significantly more symptomatic pelvic screw prominence in the iliac screw group (11.1% vs. 1.4%, P = 0.002). MDSS ≤23 mm was the strongest predictor of symptomatic pelvic screw prominence, which yielded sensitivity of 100%, specificity of 94.1%, positive predictive value of 47.6%, and negative predictive value of 100%. CONCLUSIONS: The use of the S2AI screw technique resulted in a reduced rate of symptomatic screw prominence. MDSS ≤23 mm was the strongest predictor of symptomatic screw prominence.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

September 2016

Volume

93

Start / End Page

253 / 260

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Skin
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Postoperative Complications
  • Middle Aged
  • Maryland
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ishida, W., Elder, B. D., Holmes, C., Goodwin, C. R., Lo, S.-F., Kosztowski, T. A., … Witham, T. F. (2016). S2-Alar-Iliac Screws are Associated with Lower Rate of Symptomatic Screw Prominence than Iliac Screws: Radiographic Analysis of Minimal Distance from Screw Head to Skin. World Neurosurg, 93, 253–260. https://doi.org/10.1016/j.wneu.2016.06.042
Ishida, Wataru, Benjamin D. Elder, Christina Holmes, C Rory Goodwin, Sheng-Fu L. Lo, Thomas A. Kosztowski, Ali Bydon, et al. “S2-Alar-Iliac Screws are Associated with Lower Rate of Symptomatic Screw Prominence than Iliac Screws: Radiographic Analysis of Minimal Distance from Screw Head to Skin.World Neurosurg 93 (September 2016): 253–60. https://doi.org/10.1016/j.wneu.2016.06.042.
Ishida, Wataru, et al. “S2-Alar-Iliac Screws are Associated with Lower Rate of Symptomatic Screw Prominence than Iliac Screws: Radiographic Analysis of Minimal Distance from Screw Head to Skin.World Neurosurg, vol. 93, Sept. 2016, pp. 253–60. Pubmed, doi:10.1016/j.wneu.2016.06.042.
Ishida W, Elder BD, Holmes C, Goodwin CR, Lo S-FL, Kosztowski TA, Bydon A, Gokaslan ZL, Wolinsky J-P, Sciubba DM, Witham TF. S2-Alar-Iliac Screws are Associated with Lower Rate of Symptomatic Screw Prominence than Iliac Screws: Radiographic Analysis of Minimal Distance from Screw Head to Skin. World Neurosurg. 2016 Sep;93:253–260.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

September 2016

Volume

93

Start / End Page

253 / 260

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Skin
  • Risk Factors
  • Retrospective Studies
  • Prevalence
  • Postoperative Complications
  • Middle Aged
  • Maryland
  • Male