Journal List > J Korean Soc Spine Surg > v.20(3) > 1075989

Kim, Chi, Kang, Park, Koo, Kwon, and Choy: Complications of Iliac Screw in Spinopelvic Fixation With Adult Spinal Deformity - Complications of Iliac Screw in Spinopelvic Fixation -

Abstract

Study Design

Retrospective study.

Objectives

To evaluate clinical & radiologic significance about complications of spinopelvic fixation with iliac screw in patients with adult spinal deformity.

Summary of Literature Review

Complications of iliac screw fixation in adult spinal deformity patients was obscure in spite of the good results of iliac screw fixation.

Material and Methods

We analyzed 27 patients, followed over 1-year, with adult spinal deformity (lumbar degenerative kyphosis, degenerative lumbar scoliosis, flat back syndrome). The study was done for complications of iliac screw fixation by clinical and radiological evaluations.

Results

Postoperative iliac screw prominence were 15 cases (55.5%), iliac screw breakage was 1 case (3.7%), bursitis was 1 case (3.7%), sacroiliac joint pain were 5 cases (18.5%), halo sign around iliac screw were 23 cases (85.1%), and 3 cases (11.1%) were performed reoperation. There was no significance between halo sign and sacroiliac joint pain.

Conclusions

Iliac screw fixation is a very useful operative method without severe complications on spinopelvic fixation. There are some complications of iliac screw fixation and iliac screw prominence is a most common problem, but few counterplan exits. So, further studies about reducing complication method, management protocols of iliac screw complication were needed.

Objectives

To evaluate clinical & radiologic significance about complications of spinopelvic fixation with iliac screw in patients with adult spinal deformity.

Summary of Literature Review

Complications of iliac screw fixation in adult spinal deformity patients was obscure in spite of the good results of iliac screw fixation.

Material and Methods

We analyzed 27 patients, followed over 1-year, with adult spinal deformity (lumbar degenerative kyphosis, degenerative lumbar scoliosis, flat back syndrome). The study was done for complications of iliac screw fixation by clinical and radiological evaluations.

Results

Postoperative iliac screw prominence were 15 cases (55.5%), iliac screw breakage was 1 case (3.7%), bursitis was 1 case (3.7%), sacroiliac joint pain were 5 cases (18.5%), halo sign around iliac screw were 23 cases (85.1%), and 3 cases (11.1%) were performed reoperation. There was no significance between halo sign and sacroiliac joint pain.

Conclusions

Iliac screw fixation is a very useful operative method without severe complications on spinopelvic fixation. There are some complications of iliac screw fixation and iliac screw prominence is a most common problem, but few counterplan exits. So, further studies about reducing complication method, management protocols of iliac screw complication were needed.

REFERENCES

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Figures and Tables%

Fig. 1.
The photographs demonstrate whole spine standing lateral plain radiography of 69-year-old female patient after 14 months postoperatively. Iliac screws were pulled out and skin prominence of pelvic area were found.
jkss-20-113f1.tif
Table 1.
Demographics of the patients
Variable Value
Total number (cases) 27
Sex (M/F) 0/27
Mean age (year) 69.7
Distribution classified by diseases (cases)
LDK 14
DLS with sagittal imbalance 7
Flat back syndrome 6
Mean fusion segment (level) 7.59

LDK: Lumbar degenerative kyphosis, DLS: Degenerative lumbar scoliosis

Table 2.
Complications of iliac screw
Variable Value (cases / %)
Clinical Iliac screw prominence 15/55.5
Sacroilitis 5/18.5
Bursitis 1/3.7
Wound infection 1/3.7
Radiologic c Halo sign 23/85.1
Pull-out of iliac screw 6/22
Breakage of rod 5/18.5
Pseudarthrosis 1/3.7
Breakage of iliac screw 1/3.7
Table 3.
Correlation between halo sign and sacroiliac joint pain
Variable Sacroiliac joint pain
+ Total
+ 5 30 35
Halo sign 1 18 19
Total 48 6 54
Chi-square test P=0.313
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