Abstract
BackgroundThe imaging characteristics of sacral sacralalar-iliac (S2AI) screw trajectory in adult degenerative scoliosis (ADS) patients will be determined.MethodsS2AI screw trajectories were mapped on three-dimensional computed tomography (3DCT) reconstructions of 40 ADS patients. The starting point, placement plane, screw template, and a circle centered at the lowest point of the ilium inner cortex were set on these images. A tangent line from the starting point to the outer diameter of the circle was selected as the axis of the screw trajectory. The related parameters in different populations were analyzed and compared.ResultsThe trajectory length of S2AI screws in ADS patients was 12.00 ± 0.99 cm, the lateral angle was 41.24 ± 3.92°, the caudal angle was 27.73 ± 6.45°, the distance from the axis of the screw trajectory to the iliosciatic notch was 1.05 ± 0.81 cm, the distance from the axis of the screw trajectory to the upper edge of the acetabulum was 1.85 ± 0.33 cm, and the iliac width was 2.12 ± 1.65 cm. Compared with females, the lateral angle of male ADS patients was decreased, but the trajectory length was increased (P < 0.05). Compared to patients without ADS in previous studies, the lateral angle of male patients was larger, the lateral angle of female patients was increased, and the caudal angle was decreased (P < 0.05).ConclusionsThere is an ideal trajectory of S2AI screws in ADS patients. A different direction should be noticed in the placement of S2AI screws, especially in female patients.
Highlights
The imaging characteristics of sacral sacralalar-iliac (S2AI) screw trajectory in adult degenerative scoliosis (ADS) patients will be determined
Comparison of main parameters in ADS patients of different genders Because there was no significant difference between the left and right second sacral sacralalar-iliac (S2AI) screw trajectory parameters in patients of the same gender, the main parameter data of the screw trajectory in two sides were combined and analyzed according to different genders
The results of the current study showed that there was no significant difference in the length of the screw trajectory between the male and female patients with ADS compared with previous studies, which means the data of S2AI screws in our study and previous studies are suitable for ADS patients
Summary
The imaging characteristics of sacral sacralalar-iliac (S2AI) screw trajectory in adult degenerative scoliosis (ADS) patients will be determined. With aging of the population, the overall incidence of adult degenerative scoliosis (ADS) is 8.3–68 % [1, 2]. Long segmental fixation is often required when coronal and sagittal imbalances are caused by severe deformities. Surgical treatment is Surgeons face severe challenges for long-segment fixed fusion to S1 in ADS patients. The S1 vertebral body has a structural disadvantage that is characterized by short and thick pedicles and a stress concentration is noted in the lumbosacral region after long segment fixation. ADS patients often have co-existing osteoporosis, which leads to a decrease in bone-screw interface control, resulting in poor lumbosacral fusion, false joint formation, and even orthopedic failure [5,6,7].
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