Abstract
Bilateral iliac screws are commonly used to strengthen the caudal end of lumbosacral pedicle screw fixation. Instead of bilateral iliac screws, we use bilateral sacroiliac (SI) screws to augment long lumbosacral constructs [Figure 1]. SI screws, like iliac screws, are placed in an anteriolateral direction into the hard cortical bone above the sciatic notch to optimize resistance against the cantilever moment of a long construct. In addition, SI screws penetrate both sacrum and ilium, having the added benefit of not needing sacral pedicle screws.
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