Comparison of clinical complications of iliac screw fixation versus S2 alar-iliac screw / 局解手术学杂志

ABSTRACT

Objective To compare the clinical complications between S2 alar-iliac(S2AI) screw and iliac screw(IS) fixation technique.Methods The data of 65 patients who were diagnosed as degenerative scoliosis and underwent spinopelvic fixation in our hospital from August 2010 to July 2012 were retrospectively reviewed.These patients were divided into the iliac screw fixation group (IS group) with 43 patients and the S2 alar iliac fixation group (S2AI group) with 22 patients according to different methods.The complications included screw loosening,screw breakage,acute infections,delayed wound infection and persistent pain over the gluteal region occurring longer than 3 months postoperatively were recorded.Results There were 8cases with screw loosening and 13 cases with gluteal pain in IS group,while there were no screw loosening and only 2 cases with gluteal pain in S2AI group.The average onset of gluteal pain were 11.8 months postoperatively in the IS group and 18 months postoperatively in the S2AI group.It showed that the absolute risk reduction(ARR) of screw loosening and late pain in the S2AI group was 18.6%,which was lower than 21.1% in the IS group. In the IS group, there were a total of 5 cases of delayed wound infection. Finally,3 caes of them were cured by irrigation and debridement only.and the other 2 cases were cured by irrigation and debridement with implant removal.There were no cases of delayed wound infection in the S2AI group.Conclusion The S2AI technique is associated with significantly less clinical and radiographic complications when compared with the iliac screws technique,it is a kind of internal fixation of spine and pelvis,which is worthy of being popularized by spine surgeons.