Peculiarities of spinopelvic fixation in deformations and traumatic injuries of the spine

Abstract

AIM: to evaluate the effectiveness of spinal pelvic fixation with screws inserted through the S2 vertebra into the ilium (S2AIS technique) and the use of individual pelvic support plates.
 METHODS. The analysis of the results of performing spinal-pelvic fixation in 74 patients with various pathologies of spine column and traumatic injuries (66 patients S2AIS technique, 8 patients fixation with individually made implants) was carried out.
 RESULTS. The long-term follow-up period for the patient averaged 23.5 months (from 6 to 48 months). In the group of patients with fixation using the S2AIS method, the absence of complications, requiring repeated treatment, and stable fixation in the long-term follow-up period was noted in 53 cases (78.7%). The overall incidence of malpositions out of the total number of screws established was 4.3%; only one case (0.7%) required reoperation. Fracture of the metal implant rod at the L5-S1 level (15.2%), fracture of the screws in the ilium (5%) and instability of fixation with resorption of bone tissue around the screws in the S1 vertebra and in the ilium (3%). With fixation using individual support plates, stable fixation of spinopelvic fixation in the long-term period was achieved in 5 cases; in three cases, the implants had to be removed.
 CONCLUSION. Installation of iliac screws using the S2AIS technique is the optimal method of spinopelvic fixation, allowing reliable fixation with minimal complications. In cases where traditional methods of spinopelvic fixation are impossible or technically difficult, fixation with customized implants is possible.